scholarly journals Anterior Cable Reconstruction Using the Proximal Biceps Tendon for Large Rotator Cuff Defects Limits Superior Migration and Subacromial Contact Without Restricting Range of Motion

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0016
Author(s):  
Maxwell C. Park ◽  
Charles Lin ◽  
Adam Kantor ◽  
Yasuo Itami ◽  
Michelle H. McGarry ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Contact Pressure ◽  
Repeated Measures ◽  
External Rotation ◽  
Biceps Tendon ◽  
Statistical Significance ◽  
Total Range ◽  
Peak Contact Pressure ◽  
Unbalanced Load

Objectives: Large rotator cuff defects involving the supraspinatus and infraspinatus tendons, either due to irreparability or after partial repair lack superior capsule support. Any remaining tendon is at risk for tear progression as the tendon must function as both a dynamic tendon and static ligamentous structure. Our purpose was to biomechanically assess an anterior cable reconstruction (ACR) using autologous biceps tendon. We hypothesized that ACR will normalize superior migration and subacromial contact, without limiting range of motion. Methods: Nine cadaveric shoulders were tested using a custom testing system. Glenohumeral kinematics and subacromial contact pressure were measured using a MicroScribe 3DLX and a Tekscan pressure sensor. Each specimen was tested in five conditions: Intact, Stage 2 tear (supraspinatus), Stage 2 tear + ACR, Stage 3 tear (supraspinatus + anterior half of infraspinatus), Stage 3 tear + ACR. ACR involved a biceps tendon tenotomy at the transverse humeral ligament preserving its labral attachment. ACR included “loop-around” suture fixation using two side-to-side sutures and an anchor at the articular margin in order to restore anatomy and secure the tendon along the anterior edge of the cuff defect. ACR was performed in glenohumeral 20° abduction and 60° external rotation. Specimens were tested at 0°, 20°, and 40° of glenohumeral abduction. Total rotational range of motion was measured with 2.2 Nm of torque under a physiologic muscle load. A superiorly unbalanced load was applied to measure superior translation and contact pressure. Repeated measures analysis of variance was used for statistical significance (P < 0.05). Results: The average specimen age was 58 years (range 33-77). Stage 2 and 3 tears showed increased total range of motion at all abduction angles (P < 0.007). ACR after both Stage 2 and 3 tears showed greater total range of motion at 20° abduction (P = 0.035 and P = 0.040) and 40° abduction (P = 0.003 and P < 0.001). The ACR conditions showed significantly higher total ranges of motion compared to Intact (P ≤ 0.007). Superior translation increased significantly from Intact for Stage 2 tears at 7/12 positions (P ≤ 0.014) and Stage 3 tears at all positions except 40° abduction, 90° external rotation (ER) (P < 0.001). At 0° abduction, ACR significantly decreased superior translation for Stage 2 tears at 0°, 30°, and 60° ER (P < 0.01) and Stage 3 tears at 0° and 30° ER (P < 0.001). At 20° abduction, ACR significantly reduced superior translation for Stage 2 tears at 0°, 30°, and 60° ER (P < 0.013) and Stage 3 tears at 0° and 30° ER (P < 0.004). At 40° abduction, ACR significantly decreased superior translation only for Stage 3 tears at 0° ER (P = 0.006). Peak contact pressure significantly increased with Stage 3 tears at 7/12 positions (P ≤ 0.023). ACR significantly reduced peak subacromial contact pressure for Stage 3 tears at: 0° abduction, 30° and 60° ER (P < 0.007); 20° abduction, 30° ER (P < 0.041); 40° abduction, 30° and 60° (peak only) ER (P < 0.024). Conclusion: ACR using autologous biceps tendon can biomechanically normalize superior migration and subacromial contact pressure, without limiting range of motion, similar to superior capsule reconstruction. ACR may improve rotator cuff tendon longevity by providing basic static ligamentous support while helping to maintain normal glenohumeral kinematics.

GIRD syndrome in male handball and volleyball players: Is the decrease of total range of motion the turning point to pathology?

2021 ◽  
pp. 1-8
Author(s):  
Jonas Schmalzl ◽  
Helen Walter ◽  
Wolfram Rothfischer ◽  
Sören Blaich ◽  
Christian Gerhardt ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Turning Point ◽  
External Rotation ◽  
Constant Score ◽  
High Rate ◽  
Overhead Athletes ◽  
Glenohumeral Internal Rotation Deficit ◽  
Total Range ◽  
Volleyball Players

BACKGROUND: Adaptations in glenohumeral range of motion may affect overhead athletes and lead to shoulder pathologies. OBJECTIVE: The purpose of this study was to evaluate glenohumeral internal rotation deficit (GIRD) and postero-superior impingement among male handball and volleyball players and the relationship between these pathologies and training level (amateur vs. professional), position (attack vs. no attack), experience (> 5 years vs. < 5 years) and sports. METHODS: Sixty-seven handball players and 67 volleyball players with a mean age of 25 [± 5] years were included. The range of motion including external and internal rotation in 90∘ abduction of the dominant and non-dominant shoulder was measured of each examined athlete. Visual analogue scale, disabilities of the shoulder and hand score, constant score and subjective shoulder value were recorded. The athletes were examined for postero-superior impingement and abduction force was measured with an isokinetic dynamometer. RESULTS: Internal rotation was significantly lower and external rotation was significantly greater in the dominant arm for both sports. 72% presented with GIRD. GIRD was more prevalent in athletes active for > 5 years (odds ratio (OR) 3), in those training > 3 times per week (OR 1.4) and in handball players (OR 2.7). 24% presented with postero-superior impingement. Players active for > 5 years (OR 1.22), professionals (OR 1.14), volleyball players (OR 1.19), offensive players (OR 2.2) and athletes with GIRD > 10∘ (OR 1.5) showed a higher prevalence of postero-superior impingement. CONCLUSION: GIRD is a common phenomenon in handball and volleyball players. Offensive players are frequently suffering from postero-superior impingement. GIRD > 10∘ leads in nearly 75% of the athletes to a decrease of total range of motion and a high rate of postero-superior impingement. Thus, a decreased range of motion seems to be the turning point from adaptation to pathology. Therefore, regular controls of range of motion and countermeasures by means of stretching the posterior shoulder joint should be integrated in the training content.

Evaluating the Outcomes of Rotator Cuff Repairs With Polytetrafluoroethylene Patches for Massive and Irreparable Rotator Cuff Tears With a Minimum 2-Year Follow-up

2018 ◽  
Vol 46 (13) ◽  
pp. 3155-3164 ◽  
Author(s):  
Vasanth Seker ◽  
Lisa Hackett ◽  
Patrick H. Lam ◽  
George A.C. Murrell
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
External Rotation ◽  
Case Series ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Level Of Evidence ◽  
Irreparable Tear ◽  
Pain At Rest

Background: Massive and irreparable rotator cuff tears are difficult to manage surgically. One technique is to use a synthetic polytetrafluoroethylene (PTFE) patch to bridge the tear. However, there is little information regarding the outcomes of this procedure. Purpose: To determine the ≥2-year outcomes of patients for whom synthetic patches were used as tendon substitutes to bridge irreparable rotator cuff defects. Study Design: Case series; Level of evidence, 4. Methods: This retrospective cohort study used prospectively collected data. Patients included those with a synthetic patch inserted as an interposition graft for large and/or irreparable rotator cuff tears with a minimum 2-year follow-up. Standardized assessment of shoulder pain, function, range of motion, and strength was performed preoperatively, at 6 and 12 weeks, and at 6 months and ≥2 years. Radiograph and ultrasound were performed preoperatively, at 6 months, and ≥2 years. Results: At a mean of 36 months, 58 of 68 eligible patients were followed up, and 53 of 58 (90%) patches remained in situ. Three patches failed at the patch-tendon interface, while 1 patient (2 shoulders/patches) went on to have reverse total shoulder replacements. Patient-ranked shoulder stiffness ( P < .001), frequency of pain with activity and sleep ( P < .0001), level of pain at rest and overhead ( P < .0001), and overall shoulder function improved from bad to very good ( P < .0001) by 6 months. Supraspinatus (mean ± SEM: 29 ± 16 N to 42 ± 13 N) and external rotation (39 ± 13 N to 59 ± 15 N) strength were the most notable increases at the ≥2-year follow-up ( P < .0001). Passive range of motion also improved by 49% to 67%; forward flexion, from 131° to 171°; abduction, from 117° to 161°; external rotation, from 38° to 55°; and internal rotation, from L3 to T10 ( P < .0001) preoperatively to ≥2 years. The most improvement in passive range of motion occurred between 12 months and ≥2 years. The mean (SD) Constant-Murley score was 90 (12), while the American Shoulder and Elbow Surgeons score was 95 (8). Conclusion: At 36 months postoperatively, patients who had synthetic patches used as tendon substitutes to bridge irreparable rotator cuff defects reported less pain and greater overall shoulder function as compared with preoperative assessments. They demonstrated improved range of passive motion and improved strength. The data support the hypothesis that the technique of using a synthetic PTFE patch to bridge a large and/or irreparable tear has good construct integrity and improves patient and clinical outcomes.

scholarly journals Passive Hip Range-of-Motion Values Across Sex and Sport

2018 ◽  
Vol 53 (6) ◽  
pp. 560-567 ◽  
Author(s):  
Jennifer A. Hogg ◽  
Randy J. Schmitz ◽  
Anh-Dung Nguyen ◽  
Sandra J. Shultz
Keyword(s):  
Range Of Motion ◽  
Repeated Measures ◽  
National Collegiate Athletic Association ◽  
External Rotation ◽  
Cruciate Ligament ◽  
Knee Valgus ◽  
Cross Sectional ◽  
Increased Risk ◽  
Hip Range Of Motion ◽  
Cross Country

Context:  Greater passive hip range of motion (ROM) has been associated with greater dynamic knee valgus and thus the potential for increased risk of anterior cruciate ligament injuries. Normative data for passive hip ROM by sex are lacking. Objective:  To establish and compare passive hip ROM values by sex and sport and to quantify side-to-side differences in internal-rotation ROM (ROMIR), external-rotation ROM (ROMER), and total ROM (ROMTOT). Design:  Cross-sectional study. Setting:  Station-based, preparticipation screening. Patients or Other Participants:  A total of 339 National Collegiate Athletic Association Division I athletes, consisting of 168 women (age = 19.2 ± 1.2 years, height = 169.0 ± 7.2 cm, mass = 65.3 ± 10.2 kg) and 171 men (age = 19.4 ± 1.3 years, height = 200.0 ± 8.6 cm, mass = 78.4 ± 12.0 kg) in 6 sports screened over 3 years: soccer (58 women, 67 men), tennis (20 women, 22 men), basketball (28 women, 22 men), softball or baseball (38 women, 31 men), cross-country (18 women, 19 men), and golf (6 women, 10 men). Main Outcome Measure(s):  Passive hip ROM was measured with the athlete lying prone with the hip abducted to 20° to 30° and knee flexed to 90°. The leg was passively internally and externally rotated until the point of sacral movement. Three measures were averaged for each direction and leg and used for analysis. We compared ROMIR, ROMER, ROMTOT (ROMTOT = ROMIR + ROMER), and relative ROM (ROMREL = ROMIR − ROMER) between sexes and among sports using separate 2 × 6 repeated-measures analyses of variance. Results:  Women had greater ROMIR (38.1° ± 8.2° versus 28.6° ± 8.4°; F1,327 = 91.74, P &lt; .001), ROMTOT (72.1° ± 10.6° versus 64.4° ± 10.1°; F1,327 = 33.47, P &lt; .001), and ROMREL (1.5° ± 16.0° versus −7.6° ± 16.5°; F1,327 = 37.05, P &lt; .001) than men but similar ROMER (34.0° ± 12.2° versus 35.8° ± 11.5°; F1,327 = 1.65, P = .20) to men. Cross-country athletes exhibited greater ROMIR (37.0° ± 9.3° versus 30.9° ± 9.4° to 33.3° ± 9.5°; P = .001) and ROMREL (5.9° ± 18.3° versus −9.6° ± 16.9° to −2.7° ± 17.3°; P = .001) and less ROMER (25.7° ± 7.5° versus 35.0° ± 13.0° to 40.2° ± 12.0°; P &lt; .001) than basketball, soccer, softball or baseball, and tennis athletes. They also displayed less ROMTOT (62.7° ± 8.1° versus 70.0° ± 9.1° to 72.9° ± 11.9°; P &lt; .001) than basketball, softball or baseball, and tennis athletes. Conclusions:  Women had greater ROMIR than men, resulting in greater ROMTOT and ROMREL. Researchers should examine the extent to which this greater bias toward ROMIR may explain women's greater tendency for dynamic knee valgus. With the exception of cross-country, ROM values were similar across sports. The clinical implications of these aberrant cross-country values require further study.

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 Effect of a 6-Week Weighted Baseball Throwing Program on Pitch Velocity, Pitching Arm Biomechanics, Passive Range of Motion, and Injury Rates

2018 ◽  
Vol 10 (4) ◽  
pp. 327-333 ◽  
Author(s):  
Michael M. Reinold ◽  
Leonard C. Macrina ◽  
Glenn S. Fleisig ◽  
Kyle Aune ◽  
James R. Andrews
Keyword(s):  
Range Of Motion ◽  
Training Program ◽  
Repeated Measures ◽  
External Rotation ◽  
Controlled Trial ◽  
Injury Rate ◽  
Control Group ◽  
Injury Rates ◽  
Shoulder External Rotation ◽  
Experimental Group

Background: Emphasis on enhancing baseball pitch velocity has become popular, especially through weighted-ball throwing. However, little is known about the physical effects or safety of these programs. The purpose of this study was to examine the effects of training with weighted baseballs on pitch velocity, passive range of motion (PROM), muscle strength, elbow torque, and injury rates. Hypothesis: A 6-week weighted ball training program would result in a change in pitching biomechanical and physical characteristics. Study Design: Randomized controlled trial. Level of Evidence: Level 1. Methods: During the baseball offseason, 38 healthy baseball pitchers were randomized into a control group and an experimental group. Pitch velocity, shoulder and elbow PROM, shoulder strength, elbow varus torque, and shoulder internal rotation velocity were measured in both groups. The experimental group then performed a 6-week weighted ball throwing program 3 times per week using balls ranging from 2 to 32 ounces while the control group only used a 5-ounce regulation baseball. Both groups performed a strength training program. Measurements were then repeated after the 6-week period. Injuries were tracked over the 6-week training program and the subsequent baseball season. The effect of training with a weighted ball program was assessed using 2-way repeated-measures analysis of variance at an a priori significance level of P < 0.05. Results: Mean age, height, mass, and pretesting throwing velocity were 15.3 ± 1.2 years (range, 13-18 years), 1.73 ± 0.28 m, 68.3 ± 11 kg, and 30.3 ± 0.7 m/s, respectively. Pitch velocity showed a statistically significant increase (3.3%) in the experimental group ( P < 0.001). There was a statistically significant increase of 4.3° of shoulder external rotation in the experimental group. The overall injury rate was 24% in the experimental group. Four participants in the experimental group suffered elbow injuries, 2 during the training program and 2 in the season after training. No pitchers in the control group were injured at any time during the study. Conclusion: Performing a 6-week weighted ball throwing program increased pitch velocity. However, the program resulted in increased shoulder external rotation PROM and increased injury rate. Clinical Relevance: Although weighted-ball training may increase pitch velocity, caution is warranted because of the notable increase in injuries and physical changes observed in this cohort.

Shoulder Instability and the Labrum

2018 ◽  
pp. 171-214
Author(s):  
Joaquin Sanchez-Sotelo
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Shoulder Instability ◽  
Glenohumeral Joint ◽  
Biceps Tendon ◽  
Posterior Instability ◽  
Joint Dislocation ◽  
Glenoid Labrum ◽  
Multidirectional Instability ◽  
Labral Tears

The glenohumeral joint architecture allows for a very ample range of motion. This same architecture, so beneficial for shoulder mobility, also makes the glenohumeral joint particularly prone to instability. Damage to the glenoid labrum is present in many patients with shoulder instability, although the complexity of the pathology involved in shoulder instability goes beyond labral tears. The rotator cuff and the biceps tendon, discussed in chapter 6, The Rotator Cuff and Biceps Tendon, are intimately involved with instability and the labrum; some of the concepts described in chapter 6 will apply here as well. This chapter covers shoulder instability and the labrum, including management of the acute glenohumeral joint dislocation, recurrent posterior instability and posterior labral tears, multidirectional instability, superior labral tears, failed instability surgery, and salvage procedures.

scholarly journals Postoperative stiff shoulder after open rotator cuff repair: a 3- to 20-year follow-up study

2014 ◽  
Vol 103 (4) ◽  
pp. 263-270 ◽  
Author(s):  
H. Vastamäki ◽  
M. Vastamäki
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Rotator Cuff Repair ◽  
External Rotation ◽  
Long Term Results ◽  
Shoulder Stiffness ◽  
Stiff Shoulder ◽  
Cuff Repair ◽  
Postoperative Shoulder

Background and Aims: Stiffness after a rotator cuff tear is common. So is stiffness after an arthroscopic rotator cuff repair. In the literature, however, postoperative restriction of passive range of motion after open rotator cuff repair in shoulders with free passive range of motion at surgery has seldom been recognized. We hypothesize that this postoperative stiffness is more frequent than recognized and slows the primary postoperative healing after a rotator cuff reconstruction. We wondered how common is postoperative restriction of both active and passive range of motion after open rotator cuff repair in shoulders with free passive preoperative range of motion, how it recovers, and whether this condition influences short- and long-term results of surgery. We also explored factors predicting postoperative shoulder stiffness. Material and Methods: We retrospectively identified 103 postoperative stiff shoulders among 416 consecutive open rotator cuff repairs, evaluating incidence and duration of stiffness, short-term clinical results and long-term range of motion, pain relief, shoulder strength, and functional results 3–20 (mean 8.7) years after surgery in 56 patients. Results: The incidence of postoperative shoulder stiffness was 20%. It delayed primary postoperative healing by 3–6 months and resolved during a mean 6.3 months postoperatively. External rotation resolved first, corresponding to that of the controls at 3 months; flexion and abduction took less than 1 year after surgery. The mean summarized range of motion (flexion + abduction + external rotation) increased as high as 93% of the controls’ range of motion by 6 months and 100% by 1 year. Flexion, abduction, and internal rotation improved to the level of the contralateral shoulders as did pain, strength, and function. Age at surgery and condition of the biceps tendon were related to postoperative stiffness. Conclusions: Postoperative stiff shoulder after open rotator cuff repair is a common complication resolving in 6–12 months with good long-term results.

scholarly journals Dominant-Limb Range-of-Motion and Humeral-Retrotorsion Adaptation in Collegiate Baseball and Softball Position Players

2014 ◽  
Vol 49 (4) ◽  
pp. 507-513 ◽  
Author(s):  
Elizabeth E. Hibberd ◽  
Sakiko Oyama ◽  
Justin Tatman ◽  
Joseph B. Myers
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Athletic Training ◽  
External Rotation ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Baseball Players ◽  
Glenohumeral Internal Rotation Deficit ◽  
Total Range ◽  
Collegiate Baseball

Context: Biomechanically, the motions used by baseball and softball pitchers differ greatly; however, the throwing motions of position players in both sports are strikingly similar. Although the adaptations to the dominant limb from overhead throwing have been well documented in baseball athletes, these adaptations have not been clearly identified in softball players. This information is important in order to develop and implement injury-prevention programs specific to decreasing the risk of upper extremity injury in softball athletes. Objective: To compare range-of-motion and humeral-retrotorsion characteristics of collegiate baseball and softball position players and of baseball and softball players to sex-matched controls. Design: Cross-sectional study. Setting: Research laboratories and athletic training rooms at the University of North Carolina at Chapel Hill. Patients or Other Participants: Fifty-three collegiate baseball players, 35 collegiate softball players, 25 male controls (nonoverhead athletes), and 19 female controls (nonoverhead athletes). Intervention(s): Range of motion and humeral retrotorsion were measured using a digital inclinometer and diagnostic ultrasound. Main Outcome Measure(s): Glenohumeral internal-rotation deficit, external-rotation gain, total glenohumeral range of motion, and humeral retrotorsion. Results: Baseball players had greater glenohumeral internal-rotation deficit, total–range-of-motion, and humeral-retrotorsion difference than softball players and male controls. There were no differences between glenohumeral internal-rotation deficit, total–range-of-motion, and humeral-retrotorsion difference in softball players and female controls. Conclusions: Few differences were evident between softball players and female control participants, although range-of-motion and humeral-retrotorsion adaptations were significantly different than baseball players. The throwing motions are similar between softball and baseball, but the athletes adapt to the demands of the sport differently; thus, stretching/strengthening programs designed for baseball may not be the most effective programs for softball athletes.

Effects of Hip Abduction Fatigue on Trunk and Shoulder Kinematics During Throwing and Passive Hip Rotational Range of Motion

2019 ◽  
Vol 28 (4) ◽  
pp. 304-310 ◽  
Author(s):  
Gretchen D. Oliver ◽  
Jessica K. Washington ◽  
Sarah S. Gascon ◽  
Hillary A. Plummer ◽  
Rafael F. Escamilla ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Upper Extremity ◽  
Repeated Measures ◽  
External Rotation ◽  
Convenience Sample ◽  
Fatigue Protocol ◽  
Hip Abduction ◽  
Hip Abductor ◽  
Overhead Throwing ◽  
Shoulder Kinematics

Context:Hip abductor musculature contributes to the stability of the pelvis, which is needed for efficient energy transfer from the lower-extremity to the upper-extremity during overhead throwing.Objective:The purpose of this study was to examine the effects of a bilateral hip abduction fatigue protocol on overhead-throwing kinematics and passive hip range of motion.Design:Prospective cohort study.Setting:Controlled laboratory setting.Participants:A convenience sample of 19 collegiate female softball players (20.6 [1.9] y; 169.3 [9.7] cm; 73.2 [11.2] kg).Main Outcome Measures:Repeated hip abduction to fatigue was performed on an isokinetic dynamometer for 3 consecutive days. Trunk and shoulder kinematics during throwing and hip internal and external rotation range of motion were analyzed prior to fatigue on day 1 (prefatigue) and following fatigue on day 3 (postfatigue).Results:Repeated-measures analysis of variances revealed no statistically significant differences in trunk and shoulder kinematics prefatigue and postfatigue. A statistically significant time × side × direction interaction (F2,36 = 5.462,P = .02,) was observed in hip passive range of motion. A decrease in throwing-side hip internal rotation prefatigue to postfatigue (mean difference = −2.284; 95% confidence interval, −4.302 to −0.266;P = .03) was observed.Conclusions:The hip abductor fatigue protocol used in this study did not significantly alter trunk and upper-extremity throwing kinematics. The lack of changes may indicate that fatigue of the hip abductors does not contribute to trunk and shoulder kinematics during throwing or the protocol may not have been sport-specific enough to alter kinematics.

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