Effects of 6-Week Sling-Based Training of the External-Rotator Muscles on the Shoulder Profile in Elite Female High School Handball Players

2014 ◽  
Vol 23 (4) ◽  
pp. 286-295 ◽  
Author(s):  
Cyril Genevois ◽  
Philippe Berthier ◽  
Vincent Guidou ◽  
Franck Muller ◽  
Boris Thiebault ◽  
...  
Keyword(s):  
High School ◽  
Muscle Strength ◽  
Internal Rotation ◽  
External Rotation ◽  
Large Numbers ◽  
Strengthening Exercises ◽  
Shoulder Region ◽  
Female High School ◽  
Rotation Strength ◽  
External Rotator

Context:In women's handball, the large numbers of throws and passes make the shoulder region vulnerable to overuse injuries. Repetitive throwing motions generate imbalance between shoulder internal- and external-rotator muscles. It has not yet been established whether sling-based training can improve shoulder external-rotator muscle strength.Objective:This study investigated the effectiveness of a 6-wk strengthening program in improving shoulder functional profile in elite female high school handball players.Design:Crossover study.Setting:National elite handball training center.Participants:25 elite female high school handball players.Interventions:The program, completed twice per week for 6 wk, included sling-based strengthening exercises using a suspension trainer for external rotation with scapular retraction and scapular retraction alone.Main Outcomes:Maximal shoulder external- and internal-rotation strength, shoulder external- and internal-rotation range of motion (ROM), and maximal throwing velocity were assessed preintervention and postintervention for dominant and nondominant sides.Results:After sling training, external- and internal-rotation strength increased significantly for both sides (P ≤ .001, and P = .004, respectively), with the result that there was no significant change in external- and internal-rotation strength ratios for either the dominant or the nondominant shoulder. No significant differences were observed for external-rotation ROM, while internal-rotation ROM decreased moderately, in particular in the dominant shoulder (P = .005). Maximal throwing velocity remained constant for the dominant arm, whereas a significant increase was found for the nondominant arm (P = .017).Conclusions:This 6-wk strengthening program was effective in improving shoulder external-rotator muscle strength but resulted in a decrease in the ROM in shoulder internal rotation, while throwing velocity remained stable. Adding a stretching program to this type of sling-based training program might help avoid potential detrimental effects on shoulder ROM.

Força dos Músculos Rotadores do Ombro em Indivíduos Saudáveis/ Rotator Cuff Muscle Strength in Healthy Individuals

1970 ◽  
Vol 1 (1) ◽  
pp. 78-82
Author(s):  
Paulo José Oliveira Cortez ◽  
José Elias Tomazini ◽  
Mauro Gonçalves
Keyword(s):  
Rotator Cuff ◽  
Muscle Strength ◽  
Internal Rotation ◽  
Upper Limb ◽  
Statistical Difference ◽  
External Rotation ◽  
Healthy Individuals ◽  
Average Strength ◽  
Strength Tests ◽  
The Right

Introdução: A diminuição da capacidade de exercer esforços por parte dos músculos rotadores pode criar uma variedade de problemas. O conhecimento preciso do nível de força muscular de um indivíduo é importante, tanto para a avaliação da capacidade funcional ocupacional, como para uma apropriada prescrição de exercícios atléticos e de reabilitação. Percebe-se escassez de informação sobre as articulações do ombro, bem como os fatores envolvidos na força muscular dessa região. O objetivo deste estudo foi comparar a força gerada pelos músculos do manguito rotador entre o membro superior direito e o membro superior esquerdo em indivíduos saudáveis. Métodos: Participaram do estudo 22 sujeitos do sexo masculino, com idade de 18 e 19 anos, militares, saudáveis e sem história clínica de patologia ortopédica ou qualquer tipo de lesão no sistema musculoesquelético. Foram aplicados dois testes de força: Rotação Interna e Rotação Externa. Resultado : A força média de rotação interna no membro superior direito (MSD) foi maior que a força média de rotação interna no membro superior esquerdo (MSE) (p=0,723) e a força de rotação externa no MSD foi menor que a força média de rotação externa no MSE (p=0,788). Não houve diferença estatística na comparação dos valores de força de todos os testes de força isométrica. Conclusão: Para amostra estudada e metodologia utilizada na avaliação da força muscular, não houve diferença estatística na comparação da força gerada pelos músculos do manguito rotador do membro superior direito e do membro superior esquerdo.Rotator Cuff Muscle Strength in Healthy Individuals Introduction: Decreased ability to exert efforts by the rotator muscles can create a variety of problems. The precise knowledge of the level of muscular strength of an individual is important for both the functional capacity evaluation for occupational as an appropriate exercise prescription and rehabilitation of athletic. It is perceived scarcity of information on the shoulder joints as well as factors involved in muscle strength in this region. Objective: Develop a device for measuring the strength generated by the muscles of the upper limbs and the verification of efficiency and adaptability of this device through a comparative study of muscle strength in healthy subjects. Methods: The study included 22 male subjects, aged 18 and 19 years, military personnel, body mass between 57.7 and 93 kg (71.8 ± 9.45 kg) and height between 1.67 and 1.90 m (1.75 ± 0.06 m), healthy and without a history of orthopaedic disease or any kind of damage to the musculoskeletal system. Three strength tests were applied: Internal Rotation and External Rotation. For each type of effort three maximum voluntary contractions were required for 10 seconds, with an interval of 30 seconds between each contraction.  Results: Internal rotation in the right upper limb (RUL) was higher than the average strength of internal rotation in the left upper limb (LUL) (p = 0, 723) and the external rotation strength in RUL was lower than the average strength of external rotation in the LUL (p=0,788).  No statistical difference in comparing the strength values of all isometric strength tests. Conclusion: For sample and methodology used to assess muscle strength, there was no statistical difference in comparing the force generated by the muscles of the rotator cuff of the right and left upper limb.

scholarly journals Delayed Rehabilitation Protocol after Rotator Cuff Repair

Osteology ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 29-38
Author(s):  
Alessandra Berton ◽  
Sergio De Salvatore ◽  
Vincenzo Candela ◽  
Gabriele Cortina ◽  
Daniela Lo Presti ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Muscle Strength ◽  
Internal Rotation ◽  
Outcome Measures ◽  
Rotator Cuff Repair ◽  
External Rotation ◽  
Shoulder Function ◽  
Rehabilitation Protocol ◽  
Patient Reported ◽  
Cuff Repair

Rotator cuff tears are a frequent cause of shoulder pain that often require arthroscopic repair. After surgery an intense and well-studied rehabilitation protocol is needed to obtain the complete recovery of shoulder function. Fifty patients, who sustained arthroscopic rotator cuff repair for symptomatic, atraumatic and full-thickness supraspinatus tendon tear, were involved. According to our rehabilitation protocol, during the first four postoperative weeks, the arm was supported with an abduction sling pillow, and pendulum exercises, table slide and active elbow extension and flexion were conceded. Outcome measures (Oxford shoulder score (OSS), simple shoulder test (SST), patient-reported satisfaction), shoulder function (range of motion (ROM) and muscle strength), and MRI examination were evaluated. The mean OSS score and SST score increased from 16 to 30.2 and from 5.3 to 11.4, respectively. Patient-reported satisfaction was 96%. At 12 months, patients improved ROM and muscle strength. Postoperative passive anterior elevation was 176; external rotation averaged 47; internal rotation was 90. Postoperative muscle strength during anterior elevation was 8.3 ± 2.2 kg, internal rotation 6.8 ± 3 kg, external rotation 5.5 ± 2.3 kg. Five out of seven patients with recurrent tears evaluated their results as satisfactory. They reported improvements in terms of OSS and SST mean scores despite recurrent tears; therefore, they did not undergo revision surgery. The delayed postoperative physical therapy protocol was associated with improvements in the outcome measures and shoulder function compared to the preoperatory state and rotator cuff healing demonstrated by MRI.

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.

Relationships between Knee Valgus, Hip-Muscle Strength, and Hip-Muscle Recruitment during a Single-Limb Step-Down

2009 ◽  
Vol 18 (1) ◽  
pp. 104-117 ◽  
Author(s):  
John H. Hollman ◽  
Barbara E. Ginos ◽  
Jakub Kozuchowski ◽  
Amanda S. Vaughn ◽  
David A. Krause ◽  
...  
Keyword(s):  
Muscle Strength ◽  
External Rotation ◽  
Frontal Plane ◽  
Gluteus Maximus ◽  
Knee Valgus ◽  
Outcome Measurements ◽  
Hip Muscle ◽  
Hip Abduction ◽  
Step Down ◽  
Rotation Strength

Context:Reduced strength and activation of hip muscles might correlate with increased weight-bearing knee valgus.Objective:To describe relationships among frontal-plane hip and knee angles, hip-muscle strength, and electromyographic (EMG) recruitment in women during a step-down.Design:Exploratory study.Setting:Laboratory.Participants:20 healthy women 20 to 30 years of age.Interventions:Frontal-plane hip and knee angles were measured. Gluteus maximus and medius recruitment were examined with surface EMG. Hip-abduction and -external-rotation strength were quantified with handheld dynamometry.Main Outcome Measurements:The authors analyzed correlation coefficients between knee and hip angles, gluteus maximus and medius EMG, and hip-abduction and -external-rotation strength.Results:Hip-adduction angles (r = .755, P = .001), gluteus maximus EMG (r = −.451, P = .026), and hip-abduction strength (r = .455, P = .022) correlated with frontal-plane projections of knee valgus.Conclusions:Gluteus maximus recruitment might have greater association with reduced knee valgus in women than does external-rotation strength during step-down tasks. Gluteus medius strength might be associated with increased knee valgus.

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.

scholarly journals Comparison of Shoulder Functions Between Workers With and Without Shoulder Impingement Syndrome

2020 ◽  
Author(s):  
Jun-hee Kim ◽  
Oh-yun Kwon ◽  
Chung-hwi Yi ◽  
Hye-seon Jeon ◽  
Woo-chol Joseph Choi ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Internal Rotation ◽  
External Rotation ◽  
Impingement Syndrome ◽  
Shoulder Abduction ◽  
Shoulder Impingement Syndrome ◽  
Asymmetry Ratio ◽  
Shoulder Injuries ◽  
Shoulder Impingement ◽  
The Asymmetry

The occurrence of shoulder impingement syndrome (SIS) is associated with the frequent handling and lifting of heavy loads and excessive repetitive work above the shoulder level. Thus, assembly workers have a high prevalence of shoulder injuries, including SIS. The purpose of this study was to investigate differences in shoulder ROM, muscle strength, asymmetry ratio, function, productivity, and depression between workers with and without SIS.Sixty-seven assembly line male workers (35 workers with SIS and 32 workers without SIS) participated in this study. The four shoulder ROMs and the five muscle strengths were measured using a Smart KEMA system. The asymmetry ratios were calculated using the asymmetry ratio formula; shoulder functions were measured using the shoulder pain and disability index (SPADI), disabilities of the arm, shoulder, and hand (DASH), and visual analogue scale (VAS); and Endicott work productivity scale (EWPS). Severity of depression was measured using the Beck depression inventory (BDI). Independent t-tests were performed for statistical analysis.The SPADI, DASH, and VAS values of workers with SIS were significantly higher than those of workers without SIS. Also, workers with SIS had significantly smaller shoulder internal rotation and shoulder abduction compared to workers without SIS. In addition, workers with SIS exhibited significantly lower SIR muscle strength than workers without SIS. Workers with SIS had significantly higher asymmetry ratios in shoulder internal rotation, shoulder external rotation, and elbow flexion muscle strength than workers without SIS.The SPADI and DASH scores, which indicate shoulder function, were higher, and the intensity of self-aware pain was higher in workers with SIS. Also, workers with SIS exhibited reduced SIR and SAB ROMs; decreased SIR muscle strength. Particularly, the asymmetry ratios of SIR, SER, EF muscle strength are good comparable factors for workers with and without SIS. In addition, the asymmetry ratios of shoulder muscle strengths could provide an important baseline comparison for the workers with SIS.

scholarly journals Test-Retest Reliability of Isokinetic Arm Strength Measurements in Competitive Swimmers

2018 ◽  
Vol 65 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Daniel Collado-Mateo ◽  
Francisco J. Dominguez-Muñoz ◽  
Nuno Batalha ◽  
Jose Parraça ◽  
Pablo Tomas-Carus ◽  
...  
Keyword(s):  
Internal Rotation ◽  
External Rotation ◽  
Peak Torque ◽  
Motor Patterns ◽  
Retest Reliability ◽  
General Terms ◽  
Antagonist Muscles ◽  
Test Retest Reliability ◽  
Rotation Strength ◽  
Competitive Swimmers

Abstract Swimming motor patterns lead internal rotators to grow stronger than antagonist muscles, what may increase the risk of injury in swimmers. Injury prevention often involves the improvement of external rotators strength, as well as the external rotation/internal rotation ratio. The current research aimed to evaluate the test-retest reliability of shoulder concentric rotation strength in competitive swimmers using an isokinetic dynamometer. The study enrolled 35 competitive swimmers aged between 13 and 19 years. Concentric movements were performed including internal and external rotations of the shoulder joint following the instructions of the standardized protocol. The angular velocity of the test was defined at 60º/s. Outcome measures were peak torque (Nm) and work (J), measured in both, the dominant and non-dominant arms. The external rotation/internal rotation ratio was also calculated. Reliability was excellent for peak torque and work. For the external rotation/internal rotation ratio, the ICC oscillated between 0.744 and 0.860 for the work ratio of the non-dominant arm and the peak torque ratio of the dominant arm, respectively. In general terms, better reliability was observed for peak torque compared with work, for external rotation compared with internal rotation, and for the dominant arm compared with the non-dominant one.

Gluteus Medius Activity during 3 Variations of Isometric Single-Leg Stance

2005 ◽  
Vol 14 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Jennifer E. Earl
Keyword(s):  
Internal Rotation ◽  
Repeated Measures ◽  
External Rotation ◽  
Gluteus Medius ◽  
Type Design ◽  
Strengthening Exercises ◽  
Single Leg Stance ◽  
Hip Abduction ◽  
Extremity Motion ◽  
Hip Rotation

Context:Gluteus medius (GM) contraction during single-leg stance prevents the contralateral pelvis from “dropping,” providing stability for lower extremity motion.Objective:To determine which combination of hip rotation and abduction exercise results in the greatest activity of the GM and whether the GM responds to increased loads in these exercises.Design and Setting:Repeated measures, laboratory.Subjects:20 healthy volunteers.Interventions:Resistance (2.26 and 4.53 kg) was provided to 3 variations of a single-leg-stance exercise: hip abduction only, abduction-internal rotation (ABD-IR), and abduction-external rotation.Measurements:Muscle activity was recorded from the anterior and middle portions of the GM using surface electromyography.Results:ABD-IR produced the most activity in the anterior and middle sections of the GM muscle. The 4.53-kg load produced significantly more activity than the 2.26-kg load (P< .05).Conclusions:The GM is most active when performing abduction and internal rotation of the hip. This information could be used to develop GM-strengthening exercises.

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