scholarly journals Scapular Kinematics in Athletes With and Without Rotator Cuff Tendinopathy: A Systematic Review

2020 ◽  
Vol 29 (6) ◽  
pp. 820-829
Author(s):  
Xin Fu ◽  
Patrick Shu-hang Yung ◽  
Chun Cheong Ma ◽  
Hio Teng Leong
Keyword(s):  
Rotator Cuff ◽  
Sports Participation ◽  
Small Sample ◽  
Cochrane Library ◽  
Shoulder Injuries ◽  
Overhead Athletes ◽  
3 Dimensional ◽  
Scapular Kinematics ◽  
Overhead Sports ◽  
Rotator Cuff Tendinopathy

Context: Rotator cuff tendinopathy is one of the most frequently reported shoulder injuries in athletes of overhead sports. Abnormal scapular kinematics has been proposed as one of the contributing factors of rotator cuff tendinopathy in overhead athletes. Objectives: To review the literature on 3-dimensional scapular kinematics in overhead athletes with and without rotator cuff tendinopathy. Evidence Acquisition: Electronic databases (Cochrane Library, MEDLINE, Embase, and PubMed) were searched from inception to September 2017. In addition, the reference lists of the articles that met the inclusion criteria were also searched. We included studies that compared the changes in 3-dimensional scapular kinematics in athletes with and without rotator cuff tendinopathy. Two reviewers independently examined the quality of studies by using the modified Downs and Black checklist. Evidence Synthesis: A total of 9 studies (a total of 332 athletes, mean age 23.41 [2.62] y) were included in the final analysis. The methodological quality was low (modified Downs and Black checklist = 9/15). Our findings showed a consistent pattern of increased scapular anterior tilting and internal rotation in the dominant shoulders than the nondominant shoulders of athletes who participated in overhead sports. Athletes of overhead sports seem to demonstrate an increase in scapular upward rotation during arm elevation when compared with nonathlete individuals. However, there is no consensus on the scapular kinematics pattern in athletes with rotator cuff tendinopathy when compared with healthy controls. Conclusion: Findings demonstrated that changes in scapular kinematics were observed in overhead athletes. However, all the included studies were cross-sectional studies with small sample size and diverse sports participation, whether changes in scapular kinematics may contribute to rotator cuff tendinopathy in overhead athletes warrants more high-quality prospective studies.

scholarly journals Are muscle weakness and stiffness risk factors of the development of rotator cuff tendinopathy in overhead athletes: a systematic review

2021 ◽  
Vol 12 ◽  
pp. 204062232110261
Author(s):  
Cheuk-Kin Kwan ◽  
Man-Chi Ko ◽  
Sai-Chuen Fu ◽  
Hio-Teng Leong ◽  
Samuel Ka-Kin Ling ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Risk Factor ◽  
Rotator Cuff ◽  
Muscle Weakness ◽  
Prospective Studies ◽  
Shoulder Injuries ◽  
Limited Evidence ◽  
Overhead Athletes ◽  
Rotator Cuff Tendinopathy

Background: Underlying muscle weakness and stiffness may increase the risk of developing rotator cuff tendinopathy. This systematic review aims to assess existing prospective studies to summarize whether muscle weakness and stiffness are risk factors for the development of rotator cuff tendinopathy in overhead athletes. Methods: A systematic search was performed using PRISMA guidelines. Prospective studies measuring muscle strength or stiffness and the incidence of rotator cuff tendinopathy were included. Quality assessment was performed with the Newcastle-Ottawa quality assessment scale. Results: The search yielded six studies, with a total of 523 trained overhead athletes followed up for one season. External rotation (ER) and internal rotation (IR) strength were described as protective factors against the development of rotator cuff tendinopathy. Athletes who did not sustain shoulder injuries had statistically stronger eccentric IR ( p < 0.01) and ER ( p < 0.05) strength in the pre-season assessment. Muscle stiffness indicated by limited range of motion of <106° for shoulder ER was described as a risk factor with an odds ratio of 1.12 ( p < 0.001). Imbalance between ER and IR strength was reported as risk factors for shoulder injuries in two studies, with a relative risk of 2.57 ( p < 0.05) reported in one study. Supraspinatus weakness was also reported as a risk factor for shoulder injuries in one study. Conclusion: Limited evidence support ER, IR weakness, limited ER range of motion, and very limited evidence support imbalance in ER/IR strength, and supraspinatus weakness as risk factors for rotator cuff tendinopathy in overhead athletes. No existing studies investigated the general population on this topic. Future cohort studies may improve on existing evidence with investigations on the general public, a longer follow-up time, clearly documented injury history, and a stringent diagnosis to rotator cuff tendinopathy.

scholarly journals Shoulder Injuries in Cricketers

2015 ◽  
Vol 49 (4) ◽  
pp. 194-196
Author(s):  
Sharad Prabhakar ◽  
Radhakant Pandey
Keyword(s):  
Rotator Cuff ◽  
Shoulder Injuries ◽  
Shoulder Injury ◽  
Internal Impingement ◽  
Scapular Kinematics ◽  
Glenohumeral Internal Rotation Deficit ◽  
Repetitive Nature ◽  
Tissue Changes ◽  
Soft Tissue Changes ◽  
Very High

ABSTRACT Shoulder injuries are very common in cricketers. Throwing athletes in cricket (both bowlers and fielders) are prone to shoulder injuries secondary to the large amount of forces generated, the resultant very high velocities and the repetitive nature of the throwing action. The shoulder joint has to balance mobility vs stability. Athletes exhibit adaptive changes that develop from the repetitive microtrauma following overhead throwing. The article discusses in detail how altered scapular kinematics, rotator cuff dysfunction with altered muscle strength patterns, internal impingement combined with anatomical adaptive bony and soft tissue changes causing a glenohumeral internal rotation deficit, predispose the cricketer to shoulder injury. How to cite this article Prabhakar S, Pandey R. Shoulder Injuries in Cricketers. J Postgrad Med Edu Res 2015;49(4): 194-196.

scholarly journals Risk Factors of Overuse Shoulder Injuries in Overhead Athletes: A Systematic Review

2020 ◽  
Vol 12 (5) ◽  
pp. 478-487 ◽  
Author(s):  
Camille Tooth ◽  
Amandine Gofflot ◽  
Cédric Schwartz ◽  
Jean-Louis Croisier ◽  
Charlotte Beaudart ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Rotator Cuff ◽  
Range Of Motion ◽  
Training Load ◽  
Shoulder Injuries ◽  
Shoulder Injury ◽  
Overhead Athletes ◽  
Modifiable Factors ◽  
And Training

Context: Shoulder injuries are highly prevalent in sports involving the upper extremity. Some risk factors have been identified in the literature, but consensus is still lacking. Objectives: To identify risk factors of overuse shoulder injury in overhead athletes, as described in the literature. Data Sources: A systematic review of the literature from the years 1970 to 2018 was performed using 2 electronic databases: PubMed and Scopus. Study Selection: Prospective studies, written in English, that described at least 1 risk factor associated with overuse shoulder injuries in overhead sports (volleyball, handball, basketball, swimming, water polo, badminton, baseball, and tennis) were considered for analysis. Study Design: Systematic review. Level of Evidence: Level 3. Data Extraction: Data were extracted from 25 studies. Study methodology quality was evaluated using the Modified Coleman Methodology Score. Results: Intrinsic factors, previous injury, range of motion (lack or excess), and rotator cuff weakness (isometric and isokinetic) highly increase the risk of future injuries. Additionally, years of athletic practice, body mass index, sex, age, and level of play seem to have modest influence. As for the effect of scapular dysfunction on shoulder injuries, it is still controversial, though these are typically linked. Extrinsic factors, field position, condition of practice (match/training), time of season, and training load also have influence on the occurrence of shoulder injuries. Conclusion: Range of motion, rotator cuff muscle weakness, and training load are important modifiable factors associated with shoulder injuries. Scapular dysfunction may also have influence. The preventive approach for shoulder injury should focus on these factors.

scholarly journals Shoulder External Rotation Fatigue and Scapular Muscle Activation and Kinematics in Overhead Athletes

2011 ◽  
Vol 46 (4) ◽  
pp. 349-357 ◽  
Author(s):  
Mithun Joshi ◽  
Charles A. Thigpen ◽  
Kevin Bunn ◽  
Spero G. Karas ◽  
Darin A. Padua
Keyword(s):  
Muscle Fatigue ◽  
Muscle Activation ◽  
External Rotation ◽  
Shoulder Injuries ◽  
Serratus Anterior ◽  
Overhead Athletes ◽  
Scapular Kinematics ◽  
Fatigue Protocol ◽  
Upper Trapezius ◽  
Lower Trapezius

Context: Glenohumeral external rotation (GH ER) muscle fatigue might contribute to shoulder injuries in overhead athletes. Few researchers have examined the effect of such fatigue on scapular kinematics and muscle activation during a functional movement pattern. Objective: To examine the effects of GH ER muscle fatigue on upper trapezius, lower trapezius, serratus anterior, and infraspinatus muscle activation and to examine scapular kinematics during a diagonal movement task in overhead athletes. Setting: Human performance research laboratory. Design: Descriptive laboratory study. Patients or Other Participants: Our study included 25 overhead athletes (15 men, 10 women; age = 20 ± 2 years, height = 180 ± 11 cm, mass = 80 ± 11 kg) without a history of shoulder pain on the dominant side. Intervention(s): We tested the healthy, dominant shoulder through a diagonal movement task before and after a fatiguing exercise involving low-resistance, high-repetition, prone GH ER from 0° to 75° with the shoulder in 90° of abduction. Main Outcome Measure(s): Surface electromyography was used to measure muscle activity for the upper trapezius, lower trapezius, serratus anterior, and infraspinatus. An electromyographic motion analysis system was used to assess 3-dimensional scapular kinematics. Repeated-measures analyses of variance (phase × condition) were used to test for differences. Results: We found a decrease in ascending-phase and descending-phase lower trapezius activity (F1,25 = 5.098, P = .03) and an increase in descending-phase infraspinatus activity (F1,25 = 5.534, P = .03) after the fatigue protocol. We also found an increase in scapular upward rotation (F1,24 = 3.7, P = .04) postfatigue. Conclusions: The GH ER muscle fatigue protocol used in this study caused decreased lower trapezius and increased infraspinatus activation concurrent with increased scapular upward rotation range of motion during the functional task. This highlights the interdependence of scapular and glenohumeral force couples. Fatigue-induced alterations in the lower trapezius might predispose the infraspinatus to injury through chronically increased activation.

scholarly journals Characteristics and Clinical Outcomes in Overhead Sports Athletes after Rotator Cuff Repair

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Tomoyuki Muto ◽  
Hiroaki Inui ◽  
Hiroki Ninomiya ◽  
Hiroshi Tanaka ◽  
Katsuya Nobuhara
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Rotator Cuff Tears ◽  
Aged Patients ◽  
Overhead Athletes ◽  
Cuff Tear ◽  
Rotator Cuff Injuries ◽  
Overhead Sports ◽  
Infraspinatus Tendon

Rotator cuff tears in young overhead sports athletes are rare. The pathomechanism causing rotator cuff tears in young overhead athletes is different from that in aged patients. The purpose of this study was to investigate rotator cuff tear characteristics in young overhead sports athletes to reveal the pathomechanism causing these injuries. This study included 25 overhead sports athletes less than 30 years old with atraumatic rotator cuff tears necessitating repair. Rotator cuff tear characteristics were evaluated intraoperatively, including rotator cuff tear shape and injured rotator cuff tendon. Clinical outcome measures were assessed before surgery and at the final follow-up. In this study, 22 patients reported minimal to no shoulder pain and returned to sports without significant complaints at last follow-up. The isolated infraspinatus tendon was most often injured; the incidence rate of the tear at this site was 32% (8 cases). In the deceleration phase of overhead motion, the eccentric contraction force of the ISP (infraspinatus) tendon peaks and the increased load leads to injury at the ISP tendon. The pathomechanism of rotator cuff injuries in young overhead athletes might be not only internal or subacromial impingement, but also these mechanisms.

scholarly journals Acromiohumeral Distance and 3-Dimensional Scapular Position Change After Overhead Muscle Fatigue

2015 ◽  
Vol 50 (3) ◽  
pp. 281-288 ◽  
Author(s):  
Annelies Maenhout ◽  
Famke Dhooge ◽  
Maarten Van Herzeele ◽  
Tanneke Palmans ◽  
Ann Cools
Keyword(s):  
Muscle Fatigue ◽  
Mixed Model ◽  
Tracking System ◽  
Position Change ◽  
Sports Activity ◽  
Overhead Athletes ◽  
3 Dimensional ◽  
Shoulder Muscle ◽  
Overhead Sports ◽  
Acromiohumeral Distance

Context: Muscle fatigue due to repetitive and prolonged overhead sports activity is considered an important factor contributing to impingement-related rotator cuff pathologic conditions in overhead athletes. The evidence on scapular and glenohumeral kinematic changes after fatigue is contradicting and prohibits conclusions about how shoulder muscle fatigue affects acromiohumeral distance. Objective: To investigate the effect of a fatigue protocol resembling overhead sports activity on acromiohumeral distance and 3-dimensional scapular position in overhead athletes. Design: Cross-sectional study. Setting: Institutional laboratory. Patients or Other Participants: A total of 29 healthy recreational overhead athletes (14 men, 15 women; age = 22.23 ± 2.82 years, height = 178.3 ± 7.8 cm, mass = 71.6 ± 9.5 kg). Intervention(s) The athletes were tested before and after a shoulder muscle-fatiguing protocol. Main Outcome Measure(s) Acromiohumeral distance was measured using ultrasound, and scapular position was determined with an electromagnetic motion-tracking system. Both measurements were performed at 3 elevation positions (0°, 45°, and 60° of abduction). We used a 3-factor mixed model for data analysis. Results: After fatigue, the acromiohumeral distance increased when the upper extremity was actively positioned at 45° (Δ = 0.78 ± 0.24 mm, P = .002) or 60° (Δ = 0.58 ± 0.23 mm, P = .02) of abduction. Scapular position changed after fatigue to a more externally rotated position at 45° (Δ = 4.97° ± 1.13°, P &lt; .001) and 60° (Δ = 4.61° ± 1.90°, P = .001) of abduction, a more upwardly rotated position at 45° (Δ = 6.10° ± 1.30°, P &lt; .001) and 60° (Δ = 7.20° ± 1.65°, P &lt; .001) of abduction, and a more posteriorly tilted position at 0°, 45°, and 60° of abduction (Δ = 1.98° ± 0.41°, P &lt; .001). Conclusions: After a fatiguing protocol, we found changes in acromiohumeral distance and scapular position that corresponded with an impingement-sparing situation.

Is There a Decrease in the Acromiohumeral Distance Among Recreational Overhead Athletes With Rotator Cuff–Related Shoulder Pain?

2020 ◽  
pp. 1-7
Author(s):  
Fábio Carlos Lucas de Oliveira ◽  
Amanda L. Ager ◽  
Jean-Sébastien Roy
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Pearson Correlation ◽  
Functional Limitations ◽  
Shoulder Injuries ◽  
Overhead Athletes ◽  
Recreational Athletes ◽  
Shoulder Condition ◽  
Acromiohumeral Distance ◽  
The Relationship

Context: Recreational overhead athletes are exposed to high overload, which increases the risk of shoulder injuries. Reduction of the acromiohumeral distance (AHD) is often associated with rotator cuff–related shoulder pain (RCRSP) among the general population. However, the AHD of symptomatic shoulders of recreational athletes has not yet been compared with their asymptomatic shoulders. Objective: To compare the AHD of a symptomatic to asymptomatic shoulder at rest (0°) and 60° abduction. To establish the relationship between AHD, pain, and functional limitations of recreational athletes with RCRSP. Design: Cross-sectional study. Setting: University laboratory. Participants: A total of 45 recreational overhead athletes with RCRSP were examined. Main Outcome Measures: The AHD was measured by ultrasonography at 0° and 60° abduction (angles). Shoulder pain was assessed using a numeric pain scale, whereas functional limitations were assessed using the The Disabilities of the Arm, Shoulder, and Hand questionnaire. Differences in the between-shoulders condition (symptomatic and asymptomatic) were determined using 2-way analysis of variance for repeated measures. A Pearson correlation established the relationship between AHD, pain, and functional limitations. Results: No angles × shoulder condition interactions (P = .776) nor shoulder condition effects (P = .087) were detected, suggesting no significant differences (P > .05) between asymptomatic and symptomatic shoulders in the AHD at 0° or 60°. The AHD at 60° reduced significantly compared with 0° (3.05 [1.36] mm [2.77–3.33], angle effects: P < .001). The AHD at 0° and 60° was not correlated with pain or functional limitations (−.205 ≤ r ≤ .210, .167 ≤ P ≤ .585). Conclusions: The AHD of recreational athletes is not decreased in symptomatic shoulders compared with asymptomatic shoulders. Reduction of the AHD in symptomatic shoulders is not associated with an increase in pain or functional limitations of recreational athletes with RCRSP.

scholarly journals Is Muscle Weakness a Risk Factor of the Development of Rotator Cuff Tendinopathy – A Systematic Review

2020 ◽  
Author(s):  
Cheuk-Kin Kwan ◽  
Man-Chi Ko ◽  
Sai-Chuen Fu ◽  
Samuel Ka-Kin Ling ◽  
Hio-Teng Leong ◽  
...  
Keyword(s):  
Risk Factor ◽  
Rotator Cuff ◽  
Muscle Weakness ◽  
Odds Ratio ◽  
External Rotation ◽  
Limited Range ◽  
Shoulder Injuries ◽  
Limited Range Of Motion ◽  
Rotation Strength ◽  
Rotator Cuff Tendinopathy

Abstract BackgroundUnderlying muscle weakness may explain the inconsistency in the development of rotator cuff tendinopathy in population with similar activity levels. This systematic review aims to assess existing prospective studies to evaluate whether muscle weakness is a risk factor to the development of rotator cuff tendinopathy. MethodsA systematic search was performed using the PRISMA guidelines. Prospective studies measuring muscle strength or stiffness and the incidence of rotator cuff tendinopathy will be included. Quality assessment was performed with the Newcastle-Ottawa Quality Assessment Scale. ResultsThe search yielded 6 studies, with a total of 523 trained overhead athletes followed up for 1 season. External and internal rotation strength was described as protective factors for the development of rotator cuff tendinopathy, with an odds ratio of 0.940 (p < 0.05) and 0.946 (p < 0.01) respectively for each N/m increased in force generated. Limited range of motion of <106o for shoulder external rotation was also described as a risk factor with an odds ratio of 1.12 (p < 0.001).Imbalance between external and internal rotation strength was reported as a risk factor for shoulder injuries in 2 studies, with a relative risk of 2.57 (p < 0.05) reported in 1 of them. Supraspinatus weakness was also reported as a risk factor for shoulder injuries in 1 study, with no odds ratio or relative risk provided. Due to insufficient data, combination into a meta-analysis was not possible. ConclusionsLimited evidence support that weakness of the external rotators, weakness in the internal rotators, and limited range of motion in external rotation are risk factors to the development of rotator cuff tendinopathy. Very limited evidence support that imbalance in external rotator and internal rotator strength, and supraspinatus weakness are risk factors for rotator cuff tendinopathies. Future cohort studies may improve on existing evidence with investigations on more muscle groups, a longer follow-up time, clearly documented injury history, and a stringent diagnosis to rotator cuff tendinopathy.

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