Evaluation of shoulder internal rotator muscle strength in baseball players with physical signs of glenohumeral joint instability

Background Glenohumeral joint instability is associated with structural deficits and/or alterations in sensory and motor processing; however, a proportion of patients with glenohumeral joint instability fail to respond to surgical and rehabilitative measures. This systematic review aimed to establish if functional cortical changes occur in patients with glenohumeral joint instability. Methods AMED, CINAHL, Cochrane Central Register of Controlled Trials, Embase, Medline, PEDro, Pubmed, PsychINFO and Scopus were searched from inception to 17 March 2021. Randomised controlled trials and non-randomised trials were included and quality was appraised using the Downs and Black tool. Results One thousand two hundred seventy-nine records were identified of which five were included in the review. All studies showed altered cortical function when comparing instability patients with healthy controls and included areas associated with higher cortical functions. Discussion The findings of this systematic review offer some insight as to why interventions addressing peripheral pathoanatomical factors in patients with glenohumeral joint instability may fail in some cases due to functional cortical changes. However, data are of moderate to high risk of bias. Further high-quality research is required to ascertain the degree of functional cortical changes associated with the type and duration of glenohumeral joint instability.

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Stress-Distribution Pattern Across the Glenohumeral Joint in Collegiate and Professional Baseball Players: A Computed Tomography Osteoabsorptiometry Study

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211009185 ◽

2021 ◽

Vol 9 (6) ◽

pp. 232596712110091

Author(s):

Kyosuke Numaguchi ◽

Daisuke Momma ◽

Yuki Matsui ◽

Masashi Yokota ◽

Jun Oohinata ◽

...

Keyword(s):

Bone Density ◽

Stress Distribution ◽

Glenohumeral Joint ◽

Distribution Patterns ◽

Joint Surface ◽

Baseball Players ◽

Articular Surfaces ◽

Head Surface ◽

The Mean ◽

Dominant Side

Background: The influence of long-term loading conditions on the articular surfaces of the glenohumeral joint can be determined by measuring stress-distribution patterns. Long-term pitching activity changes the stress distribution across the glenohumeral joint surface; however, the influence of competitive level on stress-distribution patterns remains unclear. Purpose: To use computed tomography (CT) osteoabsorptiometry (CTOAM) to evaluate the distribution of subchondral bone density across the glenohumeral joint in collegiate and professional baseball players as well as to determine the effects of pitching activity on the articular surfaces. Study Design: Descriptive laboratory study. Methods: We evaluated 73 shoulders in 50 baseball players. CT imaging data were obtained from the dominant-side shoulder of 12 professional pitchers (PP group) and 15 professional fielders (PF group). CT imaging data were also obtained from both shoulders of 12 asymptomatic collegiate pitchers (CP group) and 11 collegiate fielders (CF group). The pattern of distribution of subchondral bone density across the articular surfaces of each glenohumeral joint was assessed by CTOAM. As a measure of bone density, the mean Hounsfield units (HU) were obtained for each joint surface, and the absolute values of the dominant shoulder were compared for each group. Results: Stress-distribution patterns over the articular surfaces differed between the dominant and nondominant sides in the CP group as well as between both collegiate groups versus the PP group. In the CP group, the mean HU of the humeral head surface were greater on the nondominant versus dominant side ( P = .035). On the dominant side, the mean HU of the humeral head surface and glenoid were greater in the CP versus the PP group ( P = .001 and .027, respectively). Conclusion: Stress distribution on the articular surface of the glenohumeral joint was affected by pitching ability and competitive level. Our analysis indicates that the traction force on the glenohumeral joint surface might be greater than compression force during pitching. Clinical Relevance: The present findings suggest that pitching activity results in low stress to the articular surfaces of the glenohumeral joint. This supports the notion that mechanical conditions play a crucial role in the etiology of disorders specific to pitching activity.

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Postoperative Rehabilitation of Posterior Glenohumeral Joint Instability Surgery: A Systematic Review

Sports Medicine and Arthroscopy Review ◽

10.1097/jsa.0000000000000317 ◽

2021 ◽

Vol 29 (2) ◽

pp. 110-118

Author(s):

Barbra Koczan ◽

Brandon Stryder ◽

Carter Mitchell

Keyword(s):

Systematic Review ◽

Joint Instability ◽

Glenohumeral Joint ◽

Postoperative Rehabilitation

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Postoperative Rehabilitation of Anterior Glenohumeral Joint Instability Surgery: A Systematic Review

Sports Medicine and Arthroscopy Review ◽

10.1097/jsa.0000000000000305 ◽

2021 ◽

Vol 29 (2) ◽

pp. 54-62

Author(s):

Gregory Lloyd ◽

Jonathan Day ◽

Jana Lu ◽

Andrew Lincoln ◽

Sarah Attanasio ◽

...

Keyword(s):

Systematic Review ◽

Joint Instability ◽

Glenohumeral Joint ◽

Postoperative Rehabilitation

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Glenohumeral Joint Instability: Basic Science and Potential Treatment Options

360° Around Shoulder Instability ◽

10.1007/978-3-662-61074-9_43 ◽

2020 ◽

pp. 363-370

Author(s):

Lukas Ernstbrunner ◽

David Ackland ◽

Laura de Girolamo

Keyword(s):

Basic Science ◽

Joint Instability ◽

Glenohumeral Joint ◽

Treatment Options ◽

Potential Treatment

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Effects of Rehabilitation in Bankart Lesion in Non-athletes: A report of three cases

Open Medicine ◽

10.1515/med-2019-0037 ◽

2019 ◽

Vol 14 (1) ◽

pp. 369-375 ◽

Cited By ~ 1

Author(s):

Yong Hwan Kim ◽

Wi-Young So

Keyword(s):

Muscle Strength ◽

Glenohumeral Joint ◽

Sports Injury ◽

Bankart Lesion ◽

Office Worker ◽

Long Term Effects ◽

Muscle Strengthening ◽

Subsequent Performance ◽

Rehabilitation Outcomes ◽

Post Surgery

AbstractA Bankart lesion is a common traumatic sports injury of the glenohumeral joint. When the shoulder is dislocated, the connective tissue surrounding the joint may tear or rupture. This study aimed to describe the initial dislocation, treatment, medical treatment, rehabilitation outcomes at 3 and 8 months, and return to daily life for three patients. Patient 1 was a 28-year-old male office worker who enjoyed fitness and weight training. His injury was sustained by a fall from his bicycle and subsequent performance of pull-up exercises. Surgery was recommended for repair of the anterior and inferior labrum tear. Reassessment of the surgery was performed after 2 months of rehabilitation. The patient was asked to exercise once a week at a rehabilitation center and to perform home-based exercises. In the first 2 months, the main exercise consisted of range of motion (ROM) exercises and stretching. Thereafter, muscle strengthening, using tubing, equipment and body weight exercises, and proprioceptive exercises were performed to gradually improve muscle strength and for return to daily activities. ROM progressively increased, with recovery of normal range at 2 months post-surgery. However, pain decreased only slightly, with a visual analog score of 6 out of 10 at 2 months post-surgery. At 8 months, the pain was bearable, without causing discomfort. Muscle strength remained almost unchanged initially but gradually recovered, although with a residual deficit of 20–30% in flexion, adduction and internal rotation. Considering the prolonged rehabilitation after surgery, future studies are warranted to analyze the long-term effects of non-surgical therapies by accumulating more cases and developing effective exercise rehabilitation programs.

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