Muscle Strength and Range of Motion in Adolescent Pitchers with Throwing-Related Pain

2008 ◽  
Vol 36 (11) ◽  
pp. 2173-2178 ◽  
Author(s):  
James E. Trakis ◽  
Malachy P. McHugh ◽  
Philip A. Caracciolo ◽  
Lisa Busciacco ◽  
Michael Mullaney ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Range Of Motion ◽  
External Rotation ◽  
Group Versus ◽  
Bilateral Comparison ◽  
Posterior Shoulder ◽  
High Prevalence ◽  
History Of ◽  
Lower Trapezius ◽  
Shoulder Musculature

Background A high prevalence of throwing-related shoulder and elbow pain has been documented in adolescent baseball pitchers. Hypothesis Pitchers with a history of throwing-related pain will have weakened dominant-arm posterior shoulder musculature and greater dominant-arm glenohumeral total range of motion (ROM) loss compared with pitchers without throwing-related pain. Study Design Controlled laboratory study. Methods Twenty-three adolescent pitchers (age 15.7 ±1.4 years) were tested. Twelve pitchers had throwing-related pain in the prior season and were currently symptom-free, while the remaining 11 pitchers had no such history of pain. Internal and external rotation ROM and muscle strength (lower trapezius, middle trapezius, rhomboids, latissimus dorsi, supraspinatus, internal rotators, external rotators) were measured bilaterally. Dominant versus nondominant differences in ROM and strength were compared between pitchers with and without throwing-related pain. Results As a whole, the group of 23 pitchers had a loss of internal rotation ROM (13° ± 10°, P < .001) and gain in external rotation ROM (11° ± 10°, P < .001) on the dominant versus nondominant arm, with no effect on total ROM (2° ± 7° loss, P = .14). There was no difference in bilateral comparison of total ROM between pitchers with and without throwing-related pain. Dominant versus nondominant muscle strength was lower ( P < .05) for the pain group versus nonpain group for the middle trapezius (7% ± 19% vs 22% ± 12%) and supraspinatus (−4% ± 27% vs 14% ± 14%) and higher (P < .05) for the internal rotators (19% ± 14% vs 6%±12%). Conclusion Throwing-related pain in this population may be due to the inability of weakened posterior shoulder musculature to tolerate stress imparted on it by adaptively strengthened propulsive muscles. Clinical Relevance Selective posterior shoulder strengthening may be indicated in rehabilitative and injury prevention programs for adolescent pitchers.

scholarly journals Lower Trapezius Transfer for Patients With Brachial Plexus Injury

Hand ◽  
2017 ◽  
Vol 14 (2) ◽  
pp. 179-186 ◽  
Author(s):  
Bruno E. Crepaldi ◽  
José Queiroz L. Neto ◽  
Marcelo R. Rezende ◽  
Rames M. Júnior ◽  
Daniele S. Scarcella
Keyword(s):  
Quality Of Life ◽  
Muscle Strength ◽  
Brachial Plexus ◽  
Range Of Motion ◽  
Brachial Plexus Injury ◽  
External Rotation ◽  
Shoulder Abduction ◽  
Partial Recovery ◽  
Lower Trapezius

Background: Brachial plexus injury is a complex entity that often results in partial recovery. Most studies to date have focused on improving shoulder abduction. However, a recent technique has been outlined—one that transfers the lower trapezius to improve the external rotation of the shoulder. The primary objective of this study was to evaluate the gains in external rotation of the shoulder in patients who have undergone transfer of the lower trapezius; secondarily, we assessed the range of motion in the elbow and shoulder joints, as well as the muscle strength and quality of life. Methods: This article presents a prospective cohort study of 10 patients who underwent transfer of the lower trapezius. During the preoperative period and at 6 months after the operation, both active and passive goniometric measurements were assessed, as were muscle strength, Mallet’s classification, and patients’ responses to the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Results: External rotation exhibited an improvement of 17° in the active range of motion and 14° the passive range, which was not statistically significant. Flexion and active abduction of the shoulder, as well as the responses to the DASH, showed positive results. The Mallet’s classification and muscle strength measurement results were not significant. Conclusions: The procedure might be an alternative for restoration of shoulder function and glenohumeral stabilization and mainly to improve quality of life. However, additional studies are required to define and refine this surgical technique.

Infraspinatus Cross-Sectional Area and Shoulder Range of Motion Change Following Live-Game Baseball Pitching

2019 ◽  
Vol 28 (3) ◽  
pp. 236-242 ◽  
Author(s):  
Brett S. Pexa ◽  
Eric D. Ryan ◽  
Elizabeth E. Hibberd ◽  
Elizabeth Teel ◽  
Terri Jo Rucinski ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Athletic Training ◽  
Repeated Measures ◽  
External Rotation ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Shoulder Range Of Motion ◽  
Posterior Shoulder ◽  
Before And After

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.

scholarly journals A Randomized Controlled Single-Blinded Comparison of Stretching Versus Stretching and Joint Mobilization for Posterior Shoulder Tightness Measured by Internal Rotation Motion Loss

2009 ◽  
Vol 2 (2) ◽  
pp. 94-100 ◽  
Author(s):  
Robert C. Manske ◽  
Matt Meschke ◽  
Andrew Porter ◽  
Barbara Smith ◽  
Michael Reiman
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
External Rotation ◽  
Rehabilitation Program ◽  
Intervention Period ◽  
Joint Mobilization ◽  
Randomized Controlled ◽  
Posterior Shoulder ◽  
Rotation Motion ◽  
Posterior Shoulder Tightness

Background: Posterior shoulder tightness, as demonstrated by limited internal rotation range of motion, is a suggested factor in many shoulder pathologies. Methods to increase posterior shoulder mobility may be beneficial. Hypothesis: Shoulder internal rotation range of motion will not change with either of 2 interventions: cross-body stretch alone and cross-body stretch plus posterior capsule joint mobilization. Study Design: Randomized controlled single-blinded clinical trial. Methods: The study comprised 39 college-age asymptomatic participants (7 men, 32 women) who were randomly assigned to 1 of 2 groups: stretching only (n, 20) and stretching plus posterior joint mobilizations (n, 19). All had a between-shoulder difference of internal rotation of 10° or more. Shoulder internal and external rotation was measured before and after a 4-week intervention period and 4 weeks postintervention. Participants in the stretching-only group performed the cross-body stretch on the limited side. Those in the other group (cross-body stretch plus joint mobilization) were treated with posterior joint mobilization techniques on the limited side. Results: Overall means for internal rotation of the treated shoulders significantly increased over baseline at the end of the intervention period and at 4 weeks postintervention. External rotation in all shoulders remained unchanged. By the end of intervention, total motion increased significantly from baseline but decreased significantly from the end of intervention to 4 weeks postintervention. Although not statistically significant, the second group (cross-body stretch plus joint mobilization) had greater increases in internal rotation. At 4 weeks postintervention, the second group had maintained its internal rotation gains to a greater degree than those of the stretching-only group. Conclusion: Internal rotation increased in both groups. Inclusion of joint mobilization in a rehabilitation program created trends toward increased shoulder internal rotation mobility. Clinical Relevance: Both methods—cross-body stretch and cross-body stretch plus joint mobilization—may be beneficial for those with limited internal rotation range of motion.

scholarly journals Upper Extremity Musculoskeletal Characteristics and the Kerlan-Jobe Orthopaedic Clinic Questionnaire Score in Collegiate Baseball Athletes

2019 ◽  
Vol 54 (9) ◽  
pp. 945-952
Author(s):  
Mallory S. Faherty ◽  
Aldo Plata ◽  
Patrick Chasse ◽  
Robert Zarzour ◽  
Timothy C. Sell
Keyword(s):  
Upper Extremity ◽  
Athletic Training ◽  
External Rotation ◽  
Musculoskeletal Injuries ◽  
Stepwise Multiple Regression ◽  
Orthopaedic Clinic ◽  
Upper Trapezius ◽  
Posterior Shoulder ◽  
History Of ◽  
Posterior Shoulder Tightness

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.

scholarly journals EFFECT OF VISUAL AND AUDITORY FEEDBACK EXERCISES ON SHOULDER FUNCTION IN ROTATOR CUFF TENDONITIS PATIENTS

2018 ◽  
Vol 2 (109) ◽  
pp. 20-26
Author(s):  
Deimantė Jasnauskaitė-Gedrimė ◽  
Dovydas Gedrimas ◽  
Aiva Karpavičienė ◽  
Albertas Skurvydas
Keyword(s):  
Quality Of Life ◽  
Rotator Cuff ◽  
Muscle Strength ◽  
Range Of Motion ◽  
Auditory Feedback ◽  
External Rotation ◽  
Bodily Pain ◽  
Exercise Group ◽  
Shoulder Flexion

Background. There is a lot of information in literature about rotator cuff strengthening, stretching, and postural correction exercises, which are recommended as a complex for tendonitis rehabilitation (Dong et al., 2015). There is lack of information about visual and auditory feedback exercises for shoulder functions in rotator cuff tendonitis. Methods. The purpose of the study was to evaluate the effect of visual (VF) and auditory (AF) feedback exercises for shoulder functions in rotator cuff tendonitis patients. Thirty patients of Šiauliai rehabilitation centre were included in this study. Diagnostic tests, shoulder proprioception, posture, muscle strength (Lovett), functional muscle strength (Kendall), quality of life evaluations were performed before and after the study to evaluate the effect of VF and AF exercises. Results. VF exercise group had a greater increase (p < .05) in shoulder flexion abduction, internal and external rotation range of motion, proprioception, muscle strength results, also increased physical functioning, and decreased role- physical and bodily pain in the quality of life evaluation. AF exercise group demonstrated a greater increase (p < .05) in shoulder flexion abduction range of motion and muscle strength, bodily pain decreased in the quality of life evaluation. Conclusions. After comparing the results we concluded that shoulder extension, abduction, internal and external rotation range of motion and proprioception, muscle strength and the quality of life increased (p < .05) more in VF exercise group than in AF group. All in all, visual feedback exercises had greater effect onr shoulder functions and the quality of life compared to auditory feedback group. We would recommend including this type of exercises in rotator cuff tendonitis rehabilitation program.

scholarly journals Different Myofascial Release Techniques Effects on Pain and Function with Chronic Shoulder Pain in the Late Rehabilitation Period

2019 ◽  
Vol 2 (17) ◽  
Author(s):  
Darius Lipskis ◽  
Edgaras Lapinskas
Keyword(s):  
Muscle Strength ◽  
Range Of Motion ◽  
Shoulder Pain ◽  
External Rotation ◽  
Functional Mobility ◽  
Myofascial Release ◽  
Aged People ◽  
Arm Function ◽  
And Function ◽  
Chronic Shoulder Pain

Background. Joints or muscles dysfunctions more often occur not only in elderly but also middle aged people. The problem becomes chronic and causes longtermed pain, lack of functional mobility. One of the most affected areas of human musculoskeletal zones is shoulder area (Pan, 2016). Purpose. Evaluate myofascial release techniques for pain and function in patients with chronic shoulder pain. Methods. There were 12 patients chosen who were randomly divided into ischemic compression and friction groups. We evaluated pain, arm function, muscle strength and range of motion. Results. In ischemia group, pain after the treatment decreased (before 5.33 ± 0.81; after 3 ± 1.41, p = 0.01). Function of arm improved (before 42.83 ± 8.23; after 62.5 ± 6.89, p = 0.01). All humerus range of motions and strength of muscles improved (p < 0.05), comparing results before and after the treatment. In friction group pain after the treatment did not change (before 5.83 ± 0.98; after 4.16 ± 2.63, p = 0.252). Arm function improved (before 42.5 ± 4.84; after 56 ± 5.47, p = 0.006). Friction improved (p < 0.05) humerus flexion, abduction, external rotation range of motions and muscles strength of humerus abductors. Conclusions. Ischemic compression had signifcant effect on reducing shoulder pain, improving range of motion and muscle strength of humerus movers. Friction technique did not have effects on reducing pain, but had significant effects on humerus flexion, abduction, external rotation range of motions and increased muscle strength of humerus abductors. When comparing results after ischemia and friction between groups, no signifcant difference was found in treating shoulder pain, range of motion of humerus movements and muscle strength of humerus movers.Keywords: myofascial realease, friction, ischemia.

Shoulder Range of Motion Deficits in Youth Throwers Presenting With Elbow Pain

2021 ◽  
pp. 194173812110363
Author(s):  
Michael Rosen ◽  
Karim Meijer ◽  
Scott Tucker ◽  
C. Luke Wilcox ◽  
Hillary A. Plummer ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
External Rotation ◽  
Group Versus ◽  
Control Group ◽  
Pain Group ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Elbow Pain ◽  
Shoulder Range Of Motion

Background: Glenohumeral internal rotation deficit (GIRD) and total arc of motion difference (TAMD) have been associated with elbow injuries in throwing athletes. Hypothesis: Youth pitchers with elbow pain will have greater GIRD and TAMD compared with youth pitchers without elbow pain. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: Glenohumeral range of motion of 25 consecutive throwing athletes presenting with elbow pain and that of a matched control group of 18 asymptomatic throwing athletes were compared. Bilateral glenohumeral internal rotation, external rotation, and horizontal adduction at 90° were measured and GIRD and TAMD were then calculated. An analysis of variance was performed to compare range of motion between throwers with and without elbow pain. Results: The average GIRD of the elbow pain group was 32.7° compared with 14.5° in the control group ( P < 0.05). The average TAMD in the elbow pain group was 28.3° compared with 6.7° in the control group ( P < 0.05). GIRD and TAMD were present in 88% (22 of 25) and 96% (24 of 25) of the elbow pain group versus 33.3% (6 of 18) and 55.6% (10 of 18) of the control group, respectively. Conclusion: Compared with asymptomatic youth pitchers, those presenting with elbow pain have a statistically significant GIRD and TAMD. Clinical Relevance: This study suggests that a GIRD and TAMD may predispose youth pitchers to present with symptomatic elbow pain.

scholarly journals Changes in Clinical Measures and Tissue Adaptations in Collegiate Swimmers Across a Competitive Season

CommonHealth ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 37-43
Author(s):  
Ryan William Paul ◽  
Angela Tate ◽  
Joseph Sarver ◽  
Laura DiPaola ◽  
Jeffery Yim ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
External Rotation ◽  
Supraspinatus Tendon ◽  
Training Volume ◽  
Competitive Season ◽  
Posterior Shoulder ◽  
Capsule Thickness ◽  
The Relationship ◽  
Competitive Swimmers

Background: Due to high training volume, competitive swimmers incur shoulder pain and injury1, but certain physical characteristics, such as shoulder ROM and endurance, and tissue adaptations such as posterior capsule thickness (PCT) and supraspinatus tendon structure may also be risk factors. Decreased endurance and ROM have been found in competitive swimmers along with being related to pain2. However, no longitudinal studies have examined pain and disability, range of motion, training volume, shoulder endurance and tendon structure over the course of a competitive season. Purpose: The purpose of this study was to: 1) to assess shoulder pain and disability, internal rotation (IR) and external rotation (ER) and horizontal adduction (HADD) ROM, and posterior shoulder endurance longitudinally over a competitive collegiate season, and 2) determine if there is a relationship between swimming yardage, supraspinatus tendon organization and posterior capsule thickness. Methods: 17 male and 13 female Division III swimmers aged 19.6 ± 1.1 years participated. Pain and disability were assessed using the Penn Shoulder Score and the Disability of Arm Shoulder Hand sports module. Internal rotation (IR), external rotation (ER), and horizontal adduction (HA) were measured using a digital inclinometer. Shoulder endurance was measured using the Posterior Shoulder Endurance Test (PSET). Anterior, center, and posterior supraspinatus tendon images were collected by locating the anterior aspect of the tendon insertion and moving posteriorly. The ultrasound images were analyzed using custom MATlab software to quantify tissue organization. All measures were found in the beginning (T1), middle (T2), and end (T3) of the season. Repeated measure ANOVAs were used to compare longitudinal changes across time.  If p-values were found to be ≤ 0.05, follow-up paired t-tests with Bonferroni corrections were used to compare T1, T2, and T3. This protocol was IRB-approved and participants signed a written consent form. Results: An increase in swimming yardage from T1 to T2 was followed by a significant decrease in yardage to finish the swimming season (Table 1). Disability decreased and endurance increased throughout the season with no observed changes in pain. IR and HA ROM decreased significantly between all timepoint comparisons. Tendon banding frequency did not change over time (Table 2). Discussion: Large amounts of IR during the pull phase and late initiation of ER during the recovery phase have been associated with a high risk of impingement4. The relationship between pain, disability, and range of motion may suggest that a reduction of IR could protect the swimmers’ shoulder by limiting impingement through the pull and recovery phases. However, further investigation is required to confirm. The lack of statistical significance longitudinally in tendon organization is not surprising since there were no changes in pain, a decrease in disability, and an increase in endurance. Conclusion/Clinical Relevance: Further research is required to understand the relationship between training volume, tendon organization, and disability. Collegiate swimmers demonstrate increased endurance and decreased disability over the course of the season. It may suggest that the loss of ROM is a positive adaptation and may be protective.

scholarly journals Assessment of shoulder mobility in women over 60 years of age after one-sided mastectomy

2017 ◽  
Vol 20 (4) ◽  
pp. 13-16
Author(s):  
Anna Włoch ◽  
Marek Żak ◽  
Anna Opuchlik ◽  
Małgorzata Biskup ◽  
Jarosław Fabiś
Keyword(s):  
Muscle Strength ◽  
Range Of Motion ◽  
External Rotation ◽  
Radical Mastectomy ◽  
Functional Mobility ◽  
Women Patients ◽  
Shoulder Range Of Motion ◽  
Shoulder Muscle ◽  
Muscle Groups ◽  
Shoulder Muscle Strength

The overall risk of contracting various diseases, including breast cancer, increases with age. An on-going process of population ageing challenges modern physiotherapy with the need to have functional capacity in older people appreciably enhanced. The issue of anthropometric assessment of the range of motion and shoulder muscle strength is presently much underrated in the physical rehabilitation management of women patients after radical one-sided mastectomy. The study aimed to assess the functional mobility of a shoulder expressed as a range of motion, in conjunction with the assessment of shoulder muscle strength, in women patients over 60 years of age after radical one-sided mastectomy. The study comprised 24 patients (mean age 65 years) recruited from the Department of Rehabilitation, Holy Cross Cancer Centre, Kielce. All patients had undergone modifi ed radical mastectomy using the Madden technique, and an adjuvant therapy. The shoulder range of motion, i.e. flexion, abduction, internal and external rotation, was evaluated by a goniometer. Elevation, protraction and retraction movements were evaluated using an anthropometric device. A dynamometer was applied to assess the strength of select muscle groups within the shoulder during elevation, protraction and retraction motions. Statistical analysis was made with the aid of STATISTICA 12.0 software, having adopted a 0.05 alpha level as statistically signifi cant. The movements of fl exion, abduction and external rotation of the upper extremity were signifi cantly reduced on the mastectomy side. The range of motion and muscle strength during shoulder elevation, protraction and retraction were significantly diminished on the operated side (12% - 14%), compared to the non-operated one. 1. Functional mobility of the shoulder was signifi cantly reduced on the mastectomy side. 2. Results of the present study highlight the need to extend the scope of rehabilitation regimens offered to older women after radical one-sided mastectomy.

Sign in / Sign up

Export Citation Format

Share Document