scholarly journals Preseason shoulder range of motion screening and in-season risk of shoulder and elbow injuries in overhead athletes: systematic review and meta-analysis

2020 ◽  
Vol 54 (17) ◽  
pp. 1019-1027 ◽  
Author(s):  
Federico Pozzi ◽  
Hillary A Plummer ◽  
Ellen Shanley ◽  
Charles A Thigpen ◽  
Chase Bauer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Range Of Motion ◽  
External Rotation ◽  
Meta Analysis ◽  
Professional Baseball ◽  
Overhead Athletes ◽  
Shoulder Range Of Motion ◽  
Elbow Injuries ◽  
Shoulder External Rotation ◽  
Shoulder Range

ObjectiveTo characterise whether preseason screening of shoulder range of motion (ROM) is associated with the risk of shoulder and elbow injuries in overhead athletes.DesignSystematic review and meta-analysis.Data sourcesSix electronic databases up to 22 September 2018.Eligibility criteriaInclusion criteria were (1) overhead athletes from Olympic or college sports, (2) preseason measures of shoulder ROM, (3) tracked in-season injuries at the shoulder and elbow, and (4) prospective cohort design. Exclusion criteria were (1) included contact injuries, (2) lower extremity, spine and hand injuries, and (3) full report not published in English.ResultsFifteen studies were identified, and they included 3314 overhead athletes (baseball (74.6%), softball (3.1%), handball (16.1%), tennis (2.0%), volleyball (2.0%) and swimming (2.2%)). Female athletes are unrepresented (12% of the overall sample). Study quality ranged from 11 to 18 points on a modified Downs and Black checklist (maximum score 21, better quality). In one study, swimmers with low (<93°) or high (>100°) shoulder external rotation were at higher risk of injuries. Using data pooled from three studies of professional baseball pitchers, we showed in the meta-analysis that shoulder external rotation insufficiency (throwing arm <5° greater than the non-throwing arm) was associated with injury (odds ratio=1.90, 95% confidence interval 1.24 to 2.92, p<0.01).ConclusionPreseason screening of shoulder external rotation ROM may identify professional baseball pitchers and swimmers at risk of injury. Shoulder ROM screening may not be effective to identify handball, softball, volleyball and tennis players at risk of injuries. The results of this systematic review and meta-analysis should be interpreted with caution due to the limited number of studies and their high degree of heterogeneity.PROSPERO registration numberCRD42017072895.

Effectiveness of arthroscopic management of idiopathic shoulder stiffness: A meta-analysis

2021 ◽  
pp. 1-8
Author(s):  
Ya-Dong Wang ◽  
Yu-Xiang Ming ◽  
Yong-Hua Pang ◽  
Wei-Nan Chen ◽  
Xu-Hua Zong ◽  
...  
Keyword(s):  
Range Of Motion ◽  
External Rotation ◽  
Meta Analysis ◽  
Eligibility Criteria ◽  
Shoulder Stiffness ◽  
Capsular Release ◽  
Shoulder Range Of Motion ◽  
Arthroscopic Capsular Release ◽  
Shoulder Range

BACKGROUND: Persisting shoulder stiffness adversely affects quality of life by causing pain and motion restrictions especially in patients with diabetes. OBJECTIVE: The aim of this study was to evaluate the outcomes of arthroscopic capsular release in patients with idiopathic shoulder stiffness. METHOD: A literature search was conducted in electronic databases and studies were selected by following precise eligibility criteria. Random-effects meta-analyses were performed to estimate the changes at latest follow-up in scores of the Constant, American Shoulder and Elbow Surgeons (ASES), and University of California at Los Angelis (UCLA) scales, Visual Analogue Scale (VAS), and shoulder range of motion. RESULTS: Nineteen studies were included. The follow-up duration was 42 months [95% confidence interval (CI): 32, 51]. Improvements in scores of the Constant, ASES, UCLA scales, and VAS were 48.3 [95% CI: 38.0, 58.6], 44.6 [95% CI: 24.6, 64.6], 19.3 [95% CI: 16.6, 22.0], and -6.1 [95% CI: -6.9, -5.4] respectively (P< 0.05 all). Improvements in the shoulder range of motion were: abduction 82.0 [95% CI: 65.0, 98.9]; forward flexion 75.9 [95% CI: 59.7, 92.1]; external rotation 43.2 [95% CI: 37.5, 49.0]; and internal rotation 25.4 [95% CI: 15.2, 35.5] degrees; P< 0.05 all). CONCLUSION: Arthroscopic capsular release effectively improves shoulder function in patients with idiopathic shoulder stiffness.

scholarly journals The Relationship Between Shoulder Range of Motion and Arm Stress in College Pitchers: A MOTUS Baseball Study

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0040
Author(s):  
Caleb Gulledge ◽  
Toufic Jildeh ◽  
Joseph Tramer ◽  
Fabien Meta ◽  
Kevin Taylor ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Upper Extremity ◽  
Internal Rotation ◽  
External Rotation ◽  
Outcome Measurement ◽  
Overhead Athletes ◽  
Shoulder Range Of Motion ◽  
Patient Reported ◽  
The Relationship ◽  
Shoulder Range

Objectives: Overuse injuries in overhead athletes are becoming more prevalent, with an unclear relationship between shoulder biomechanics and medial elbow symptoms and injury. The purpose of this study was to investigate the relationship of shoulder range of motion to torque across the medial elbow in college pitchers using a validated MOTUS sensor baseball sleeve. Methods: Pitchers were recruited from three local university baseball teams. Exclusion criteria included injury or restricted activity due to pain. They were evaluated in the preseason, within two weeks before their first game of the season. Pitchers completed workload questionnaires and patient reported outcome measurement information system (PROMIS) pain interference (PI), physical function (PF), and upper extremity (UE) surveys. Shoulder range of motion and upper extremity lengths were measured bilaterally. After adequate warm-up, pitchers were fitted with a MOTUS sensor baseball sleeve (Motus Global, Massapequa, NY) and instructed to throw 5 fastballs in a standardized manner off the mound at game-speed effort. The sensor placed at the medial elbow reported elbow torque, arm speed, arm slot, and shoulder rotation for each pitch, while a radar gun measured peak ball velocity. The primary outcome was to evaluate the relationship between shoulder range of motion and increased stress across the medial elbow. Additional outcomes evaluated pitcher characteristics, demographics, and outcome scores. Outcomes were assessed via a multivariable model, which controlled for possible covariates. Results: Twenty-eight pitchers were included in the preseason analysis with an average (SD) age of 20.1 (1.3) years and playing experience of 15.3 (1.8) years, 2.5 (1.2) of those years at collegiate level. The dominant shoulder demonstrated decreased internal rotation (54.5+/-10.6 vs 65.8+/-9.1) and increased external rotation (ER, 94.1+/-10.4 vs 88.4+/-9.2) relative to the non-dominant side (p < 0.001), while total rotational range of motion (TRROM) was significantly decreased in the dominant arm (148.6+/-12.4 vs 154.1+/-10.6, p < 0.001). The average glenohumeral internal rotation deficiency (GIRD) was 11.3 (9.87) and average external rotation gain (ERG) was 5.71 (8.8). External rotation was found to be a predictor of arm stress, with an increase in 0.35 Nm of elbow torque for every degree increase in ER (beta = 0.35+/-0.06, p = 0.003); there was moderate correlation between ER and arm stress (r = .45, P<.001). Pitchers demonstrated significantly greater arm stress with the following shoulder ROM measurements: GIRD < 20 as compared to greater than 20 degrees (46.6 +/- 0.5 versus 43.5 +/- 1.1, P=.011), ERG greater than 5 as compared to < 5 degrees (47.4 +/- 0.7 versus 45.1 +/- 0.6, P=.014), and loss of total rotational ROM less than 5 as compared to > 5 degrees (46.6 +/- 0.5 versus 43.6 +/- 1.1, P=.013). Multivariate analysis demonstrated significant predictors of PROMIS PF and UE scores were arm stress, ERG, and GIRD (p<0.05), while increased PROMIS PI scores were predicted by increased ERG and GIRD (p<0.05). Conclusion: We found medial elbow stress, arm speed, arm slot, and shoulder rotation as measured by the MOTUS baseball sensor sleeve were influenced by rotational adaptations of the pitching shoulder in collegiate throwing athletes prior to their season. Likewise, arm stress and shoulder rotational adaptations were reflected as predictors of PROMIS PF, UE, and PI scores.

Comparing the Effects of Total Motion Release® to Stretching for Increases in Internal and External Rotation at the Shoulder

2021 ◽  
pp. 1-7
Author(s):  
Nicole Sordello ◽  
Tenli Bright ◽  
Taylor Truesdell ◽  
Jace Puckett ◽  
Jayme G. Baker ◽  
...  
Keyword(s):  
Range Of Motion ◽  
External Rotation ◽  
Clinical Question ◽  
Bottom Line ◽  
Warm Up ◽  
Overhead Athletes ◽  
Shoulder Range Of Motion ◽  
Shoulder Range

Focused Clinical Question: What are the effects of Total Motion Release® on shoulder range of motion compared with stretching in overhead athletes? Clinical Bottom Line: Total Motion Release® significantly improved acute dominant and nondominant shoulder ROM compared with dynamic warm-up and stretching protocols. The application of Total Motion Release® was also found to produce significantly larger increases in shoulder ROM and took substantially less time to complete when compared with dynamic warm-up protocols.

scholarly journals Shoulder Range of Motion and Baseball Arm Injuries: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 53 (12) ◽  
pp. 1190-1199 ◽  
Author(s):  
Garrett S. Bullock ◽  
Mallory S. Faherty ◽  
Leila Ledbetter ◽  
Charles A. Thigpen ◽  
Timothy C. Sell
Keyword(s):  
Range Of Motion ◽  
External Rotation ◽  
Meta Analysis ◽  
P Value ◽  
High Quality ◽  
Level Of Evidence ◽  
Baseball Players ◽  
Shoulder Range Of Motion ◽  
Methodologic Quality ◽  
Arm Injuries

Objective Arm injuries in baseball players are a common problem. The identification of modifiable risk factors, including range of motion (ROM), is essential for injury prevention. The purpose of this review was to assess the methodologic quality and level of evidence in the literature and to investigate the relationship between shoulder ROM and the risk of arm injuries in baseball players. Data Sources Relevant studies in PubMed, CINAHL, Embase, and SPORTDiscus published from inception to August 1, 2017. Study Selection Only studies that encompassed healthy baseball cohorts who were assessed for shoulder ROM and prospectively evaluated for injuries throughout a baseball season or seasons were included. Data Extraction Six articles met the search criteria. Only 3 studies were included in the meta-analysis due to disparate participant groups. Data Synthesis The modified Downs and Black scale (0–15 points) was used to analyze methodologic quality. Study quality ranged from 11 to 14. Four studies received high-quality (≥12) and 2 studies received moderate-quality (≥10) scores. The overall pooled analysis demonstrated that absolute and internal-rotation deficits (–5.93 [95% confidence interval {CI} = –9.43, –2.43], P &lt; .001 and 4.28 [0.71, 7.86], P = .02, respectively) and absolute total ROM (TROM; –6.19 [95% CI = –10.28, –2.10]; P = .003) were predictors of injury, and these data exhibited homogeneity (absolute IR P value = .77, I2 = 0%; IR deficit P value = .41, I2 = 0%; absolute TROM P value = .78, I2 = 0%). No significance was observed for absolute external rotation (–2.86 [95% CI = –6.56, 0.83], P = .13), which had data with high heterogeneity (P = .003; I2 = 83%). A deficit in horizontal adduction was a predictor of injury (–8.32 [95% CI = –12.08, –4.56]; P &lt; .001); these data were homogeneous but yielded a moderate heterogenic effect (P = .16; I2 = 50%). Conclusions High-quality evidence demonstrated that deficits in throwing-arm TROM and IR were associated with upper extremity injury in baseball players. Heterogeneity across studies for horizontal adduction suggested that this may be a modifiable risk factor for injury, but it requires further research.

Influence of a Pre-throwing Protocol on Range of Motion and Strength in Baseball Athletes

2020 ◽  
Author(s):  
Jessica Downs ◽  
Kyle Wasserberger ◽  
Gretchen D. Oliver
Keyword(s):  
Range Of Motion ◽  
External Rotation ◽  
Isometric Strength ◽  
Intervention Teams ◽  
Shoulder Range Of Motion ◽  
Hip Range Of Motion ◽  
Control Team ◽  
Overhand Throwing ◽  
Intervention Team ◽  
Shoulder Range

AbstractThough chronic overhand throwing is known to result in range of motion and strength adaptations, there is limited research regarding interventions for maintenance of these characteristics. Therefore, the purposes of this study were to explore the use of a pre-throwing protocol focusing on lumbopelvic-hip complex musculature in high school baseball players and examine its effects on shoulder and hip range of motion and isometric strength over the course of a season. Four exercises were added to the intervention team’s warm-up routine. The control and intervention teams’ passive bilateral hip and shoulder range of motion and isometric strength were assessed pre/post-season. A multivariate analysis of variance revealed significant differences in delta scores between the teams for multiple shoulder and hip range of motion and isometric strength variables. Key results were the intervention team lost significantly more stride hip external rotation but gained more isometric strength than the control team. The intervention team was also able to better maintain shoulder range of motion than the control team. Practitioners should use the results of this study and consider incorporating exercises that target lumbopelvic-hip complex musculature into their current training program.

Shoulder Range of Motion and Strength Characteristics in Circus Acrobats

2020 ◽  
Vol 35 (3) ◽  
pp. 145-152
Author(s):  
Carlie Huberman ◽  
Melissa Scales ◽  
Srikant Vallabhajosula
Keyword(s):  
General Population ◽  
Range Of Motion ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Hand Dominance ◽  
Cross Sectional ◽  
Shoulder Range Of Motion ◽  
Shoulder Strength ◽  
Shoulder Complex ◽  
Shoulder Range

OBJECTIVES: To begin to establish normative data for shoulder range of motion (ROM) and strength in the circus acrobats and to compare these values based on age, sex, hand dominance, and acrobatic subgroup. METHODS: Active (AROM) and passive (PROM) of the full shoulder complex and PROM of the isolated glenohumeral joint were measured in 193 circus acrobats using standardized techniques for anterior elevation (flexion), posterior elevation (extension), lateral elevation (abduction), and external and internal rotation. Shoulder strength was measured using a hand-held dynamometer in all planes of motion. Measurements were taken twice and averaged. Mixed ANOVA were performed. One-sample t-tests were used to compare with general population. RESULTS: Several significant differences were noted between dominant and non-dominant sides, but not between the sex or age groups tested. Acrobats who did both aerial and ground acrobatics had significantly greater full shoulder complex flexion AROM than the aerial group, and AROM extension than the ground group. Circus acrobats had significantly greater AROM full shoulder complex extension, abduction, internal and external rotation, and shoulder strength than the general population. CONCLUSION: Overall, results from this cross-sectional study revealed that circus acrobats had greater shoulder strength and ROM than the general population, which could affect the way these patients should be treated in a clinical setting. Age and sex seemed to have minimal effects, but there was clearly an effect of hand dominance. Acrobats who train both aerial and ground acrobatics may have greater ROM in certain planes than those who train in only one type of discipline.

scholarly journals Correlation of 3-Dimensional Shoulder Kinematics to Function in Subjects With Idiopathic Loss of Shoulder Range of Motion

2005 ◽  
Vol 85 (7) ◽  
pp. 636-647 ◽  
Author(s):  
Peter J Rundquist ◽  
Paula M Ludewig
Keyword(s):  
Range Of Motion ◽  
Multiple Regression ◽  
External Rotation ◽  
Regression Equation ◽  
Multiple Regression Equation ◽  
3 Dimensional ◽  
Shoulder Range Of Motion ◽  
Shoulder Kinematics ◽  
And Function ◽  
Shoulder Range

AbstractBackground and Purpose. People with idiopathic loss of shoulder range of motion (ROM) have difficulty completing activities of daily living. This investigation was performed to determine the association between active glenohumeral ROM and function and to develop a multiple regression equation to explain variation in function in people with idiopathic loss of shoulder motion. Subjects and Methods. This was a comparative study of 21 subjects (18 female, 3 male), using measurements of shoulder kinematics and administration of the Shoulder Rating Questionnaire (SRQ). Electromagnetic tracking sensors monitored the 3-dimensional position of the scapula and humerus throughout active shoulder motions. Correlations were performed between the active ROMs of interest and various demographic factors and the SRQ. A multiple regression equation was generated. Results. A multiple regression equation including scapular-plane abduction, external rotation at the side, external rotation at 90 degrees of abduction, and weight explained 69% of the variation in the SRQ scores. Discussion and Conclusion. The results suggest that active ROM can be used to predict function in people with idiopathic loss of shoulder ROM.

scholarly journals The Comparison of Instrument-Assisted Soft Tissue Mobilization and Self-Stretch Measures to Increase Shoulder Range of Motion in Overhead Athletes: A Critically Appraised Topic

2018 ◽  
Vol 27 (4) ◽  
pp. 385-389 ◽  
Author(s):  
Matthew J. Hussey ◽  
Alex E. Boron-Magulick ◽  
Tamara C. Valovich McLeod ◽  
Cailee E. Welch Bacon
Keyword(s):  
Soft Tissue ◽  
Range Of Motion ◽  
Internal Rotation ◽  
Proper Function ◽  
Clinical Question ◽  
Bottom Line ◽  
Overhead Athletes ◽  
Shoulder Range Of Motion ◽  
Soft Tissue Mobilization ◽  
Shoulder Range

Clinical Scenario: Shoulder range of motion (ROM) in throwing athletes relies on a balance of mobility and stability to maintain proper function and health that, if disrupted, can lead to shoulder injury. There have been several studies that address the relationship between ROM deficits and overhead injuries; however, it may be unclear to clinicians which interventions are most effective for increasing ROM in the glenohumeral joints of overhead athletes. Clinical Question: In overhead athletes who have deficient shoulder ROM, is instrument-assisted soft tissue mobilization (IASTM) more effective at acutely increasing ROM over the course of a patient’s treatment when compared with self-stretching? Summary of Key Findings: A thorough literature review yielded 3 studies relevant to the clinical question, and all 3 studies were included. Two articles found a significant increase in acute ROM when compared with a self-stretch measure. All 3 articles showed increases in internal rotation and horizontal adduction, and 1 study reported an increase in total arc of shoulder ROM. Clinical Bottom Line: There is moderate evidence to support the use of IASTM to acutely increase ROM in the glenohumeral joint of overhead athletes. Clinicians should be aware of the variability with recommended treatment times; however, positive results have been seen with treatments lasting 5 to 6 minutes per treatment region. There is no consensus for treatment intensity, and certain IASTM tools require certification. Strength of Recommendation: Grade B evidence exists that IASTM is more effective at increasing shoulder ROM (ie, internal rotation, horizontal adduction, external rotation, total arc of motion) in overhead athletes than self-stretching measures.

scholarly journals Glenohumeral Internal Rotation Deficit and Risk of Upper Extremity Injury in Overhead Athletes: A Meta-Analysis and Systematic Review

2018 ◽  
Vol 10 (2) ◽  
pp. 125-132 ◽  
Author(s):  
Robert A. Keller ◽  
Anthony F. De Giacomo ◽  
Julie A. Neumann ◽  
Orr Limpisvasti ◽  
James E. Tibone
Keyword(s):  
Systematic Review ◽  
Range Of Motion ◽  
Upper Extremity ◽  
Internal Rotation ◽  
Meta Analysis ◽  
Mean Difference ◽  
Extremity Injury ◽  
Overhead Athletes ◽  
Glenohumeral Internal Rotation Deficit ◽  
Upper Extremity Injury

Context: Current perception dictates that glenohumeral internal rotation deficit (GIRD) is a chronic adaptation that leads to an increased risk of pathologic conditions in the dominant shoulder or elbow of overhead athletes. Objective: To determine whether adaptations in glenohumeral range of motion in overhead athletes lead to injuries of the upper extremity, specifically in the shoulder or elbow. Data Sources: An electronic database search was performed using Medline, Embase, and SportDiscus from 1950 to 2016. The following keywords were used: GIRD, glenohumeral internal rotation deficit, glenohumeral deficit, shoulder, sport, injury, shoulder joint, baseball, football, racquet sports, volleyball, javelin, cricket, athletic injuries, handball, lacrosse, water polo, hammer throw, and throwing injury. Study Selection: Seventeen studies met the inclusion criteria for this systematic review. Of those 17 studies, 10 included specific range of motion measurements required for inclusion in the meta-analysis. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 4. Data Extraction: Data on demographics and methodology as well as shoulder range of motion in various planes were collected when possible. The primary outcome of interest was upper extremity injury, specifically shoulder or elbow injury. Results: The systematic review included 2195 athletes (1889 males, 306 females) with a mean age of 20.8 years. Shoulders with GIRD favored an upper extremity injury, with a mean difference of 3.11° (95% CI, –0.13° to 6.36°; P = 0.06). Shoulder total range of motion suggested increased motion (mean difference, 2.97°) correlated with no injury ( P = 0.11), and less total motion (mean difference, 1.95°) favored injury ( P = 0.14). External rotational gain also favored injury, with a mean difference of 1.93° ( P = 0.07). Conclusion: The pooled results of this systematic review and meta-analysis did not reach statistical significance for any shoulder motion measurement and its correlation to shoulder or elbow injury. Results, though not reaching significance, favored injury in overhead athletes with GIRD, as well as rotational loss and external rotational gain.

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