scholarly journals Four-Dimensional Computed Tomography Evaluation of Shoulder Joint Motion in Collegiate Baseball Pitchers

2021 ◽  
Author(s):  
Daisuke Momma ◽  
Alejandro A Espinoza Orías ◽  
Tohru Irie ◽  
Tomoyo Irie ◽  
Eiji Kondo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Internal Rotation ◽  
Contact Area ◽  
Humeral Head ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Ct Scanning ◽  
4D Ct ◽  
Collegiate Baseball ◽  
Baseball Pitchers

Abstract The purpose of this study is to evaluate the glenohumeral contact area, center of glenohumeral contact area, and center of humeral head during simulated pitching motion in collegiate baseball pitchers using four-dimensional computed tomography (4D CT). We obtained 4D CT data from the dominant and non-dominant shoulders of eight collegiate baseball pitchers during the cocking motion. CT image data of each joint were reconstructed using a 3D reconstruction software package. The glenohumeral contact area, center of glenohumeral contact area, center of humeral head, and oblateness of humeral head were calculated from 3D bone models using customized software. The center of glenohumeral contact area translated significantly from anterior to posterior during maximum external rotation to maximum internal rotation. The center of humeral head translated from posterior to anterior during maximum external rotation to maximum internal rotation. There was a high negative correlation between anterior translation of the center of glenohumeral contact area and center of humeral head, and a positive correlation between the translation and the oblateness. 4D CT analyses demonstrated that the center of humeral head translated in the opposite direction to that of the center of glenohumeral contact area during external rotation to internal rotation in abduction in the dominant and non-dominant shoulders. This diametric translation can be explained by the oblateness of the humeral head. 4D CT scanning and the software for bone surface modeling of the glenohumeral joint enabled quantitative assessment of glenohumeral micromotion and identified humeral head oblateness as the cause of diametric change.

scholarly journals Internal Rotation and Scapular Position Differences: A Comparison of Collegiate and High School Baseball Players

2010 ◽  
Vol 45 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Stephen J. Thomas ◽  
Kathleen A. Swanik ◽  
Charles B. Swanik ◽  
John D. Kelly
Keyword(s):  
High School ◽  
Internal Rotation ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Scapular Dyskinesis ◽  
Position Change ◽  
Baseball Players ◽  
Glenohumeral Internal Rotation Deficit ◽  
Rotator Cuff Injuries ◽  
Collegiate Baseball

Abstract Context: Conditions such as labral and rotator cuff injuries have been linked with decreases in glenohumeral internal-rotation and increases in external-rotation motion. Also, decreased glenohumeral internal rotation is strongly associated with scapular dyskinesis. Objective: To compare healthy collegiate and high school baseball players' glenohumeral joint range of motion and scapular position. Design: Cross-sectional study. Setting: Institutional research laboratory. Patients or Other Participants: Thirty-one male National Collegiate Athletic Association Division I collegiate (age  =  20.23 ± 1.17 years, height  =  186.24 ± 5.73 cm, mass  =  92.01 ± 7.68 kg) and 21 male high school baseball players (age  =  16.57 ± 0.76 years, height  =  180.58 ± 6.01 cm, mass  =  79.09 ± 11.51 kg). Main Outcome Measure(s): Glenohumeral internal and external rotation and scapular upward rotation were measured with a digital inclinometer. Scapular protraction was measured with a vernier caliper. All variables except scapular upward rotation were calculated as the difference between the dominant and nondominant sides. Results: Collegiate baseball players had more glenohumeral internal-rotation deficit (4.80°, P  =  .028) and total motion deficit (5.73°, P  =  .009) and less glenohumeral external-rotation gain (3.00°, P  =  .028) than high school players. Collegiate baseball players had less scapular upward rotation than high school players at the 90° (4.12°, P  =  .015, versus 3.00°, P  =  .025) and 120° (4.00°, P  =  .007, versus 3.40°, P  =  .005) positions. The scapular protraction difference was greater in collegiate baseball players than in high school players in the hands-on-hips and 90° positions (0.77 cm, P  =  .021, and 1.4 cm, P  =  .001). Conclusions: When comparing high school with collegiate baseball players, these data suggest that glenohumeral internal-rotation deficit and scapular position change as the level of competition increases.

Quantification of Anterior Translation of the Humeral Head in the Throwing Shoulder

2000 ◽  
Vol 28 (2) ◽  
pp. 161-167 ◽  
Author(s):  
Todd S. Ellenbecker ◽  
Angelo J. Mattalino ◽  
Eric Elam ◽  
Roger Caplinger
Keyword(s):  
Clinical Evaluation ◽  
Humeral Head ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Professional Baseball ◽  
Intrarater Reliability ◽  
Stress Radiography ◽  
Significant Difference ◽  
Baseball Pitchers ◽  
Head Translation

Clinical evaluation of humeral head translation relies mainly on manual tests to measure laxity in the human shoulder. The purposes of this study were to determine whether side-to-side differences exist in anterior humeral head translation in professional baseball pitchers, to compare manual laxity testing with stress radiography for quantifying humeral head translation, and to test intrarater reliability of the manual humeral head translation and stress radiography tests. Twenty professional baseball pitchers underwent bilateral manual anterior humeral head translation and stress radiographic tests. Stress radiography was performed by imparting a 15-daN anterior load to the shoulder in 90° of abduction with both neutral and 60° of external rotation and recording the glenohumeral joint translation at rest and under stress in each position. Eight subjects were retested to assess the reliability of these methods. Results showed no significant difference between the dominant and nondominant extremity in the amount of anterior humeral head translation measured manually and with stress radiography, nor significant correlation between anterior humeral head translation measured manually and by stress radiography. Testretest reliability was moderate-to-poor for the manual humeral head translation test and moderate for stress radiography.

scholarly journals The Relationship between the Glenohumeral Joint Internal Rotation Deficit and the Trunk Compensation Movement in Baseball Pitchers

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 243
Author(s):  
Shih-Chung Cheng ◽  
Ting-Yu Wan ◽  
Chun-Hao Chang
Keyword(s):  
High School ◽  
Internal Rotation ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Senior High School ◽  
Control Group ◽  
Trunk Rotation ◽  
Baseball Pitchers ◽  
The Relationship ◽  
Dominant Side

Background and objectives: Glenohumeral joint internal rotation deficit (GIRD) is commonly observed in the dominant arm of baseball pitchers and is limited by horizontal adduction motions. We inferred that when pitchers’ generation of internal shoulder rotation and horizontal adduction activity is limited, they may generate compensation movements in other body parts. This study aims to investigate whether pitchers with GIRD generates trunk compensation during pitching where pitching targets were on the lower corner of their non-dominant side. Design: Case-control study. Setting: Elite senior high school baseball. Participants: Twenty-five senior high school baseball pitchers participated in this study. Twelve pitchers with GIRD were assigned to the experiment group, and the remaining 13 participants to the control group. Main outcome measures: Glenohumeral internal/external rotation of both arms and internal/external rotation of the bilateral hip joints were measured. The kinematic values of the trunk when pitching to a target were measured using high-speed infrared cameras. Results: Pitchers with GIRD exhibited significantly greater upper trunk rotation toward the non-dominant side when a baseball was released from their hand (27.39 ± 6.62 degrees), compared with non-GIRD pitchers (20.42 ± 5.97 degrees) (p < 0.05). The total rotation of the pivot leg of pitchers with GIRD (67.54 ± 7.84 degrees) was significantly smaller than that of pitchers without GIRD (74.00 ± 7.07 degrees) (p < 0.05). Conclusions: GIRD in the dominant arm affected upper trunk rotation during pitching and was associated with the hip range of motion. Future studies could conduct a longitudinal study regarding the relationship between GIRD and other joint injuries of the lower limbs.

scholarly journals Derotational Osteotomies for The Late Treatment of Brachial Plexus Injury

2021 ◽  
Author(s):  
Ahmet Emrah Açan ◽  
Ertuğrul Şahin
Keyword(s):  
Brachial Plexus ◽  
Internal Rotation ◽  
Humeral Head ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Older Children ◽  
Adductor Muscles ◽  
Late Treatment ◽  
Obstetric Brachial Plexus ◽  
Teres Major

Obstetric brachial plexus palsy [OBBP] can affect the function of the upper extremity. Most of the injuries are limited to the upper spinal nerves and heals spontaneously. However, some of them will have incomplete recovery after OBBP often results in weakness of the external rotators [teres minor and infraspinatus] muscles compared to the internal rotators [teres major, pectoralis major, latissimus dorsi] muscles. The predominance of the internal rotators and adductor muscles over external rotators leads to an internal rotation contracture. The development of internal rotational deformity may progress to increased glenoid retroversion and posterior humeral head subluxation. If the surgeon does not repair internal rotation deformity, the humeral head is forced into a posterior position causing a complete posterior dislocation. Many procedures are performed to treat these deformities: In the young child, improving the remodeling of the glenohumeral joint, capsulectomy, and subscapular release are introduced. Tendon transfers of the shoulder have good results for motion but fail to restore the glenohumeral joint. The failure of improving joint alignment may represent the loss in clinical improvement over time. In older children, a humeral osteotomy can be an alternative to realign the limb into external rotation, improve appearance, and enhance eating, washing hair, and scratching the back of the neck. We will discuss all the techniques along with their advantages and disadvantages.

scholarly journals Anatomy and Biomechanic of the Shoulder

2019 ◽  
Vol 7 (11_suppl6) ◽  
pp. 2325967119S0046
Author(s):  
Troydimas Panjaitan
Keyword(s):  
Rotator Cuff ◽  
Humeral Head ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Central Component ◽  
Subscapularis Tendon ◽  
Glenoid Fossa ◽  
Greater Tuberosity ◽  
Glenohumeral Ligaments ◽  
Shoulder Complex

The shoulder is one of the most complex joints of the human body. Consequently, they are susceptible to injury and degeneration. Mechanical shoulder pathology typically results when overuse, extremes of motion, or excessive forces overwhelm intrinsic material properties of the shoulder complex resulting in tears of the rotator cuff, capsule, and labrum. The fundamental central component of the shoulder complex is the glenohumeral joint. It has a ball-and-socket configuration with a surface area ratio of the humeral head to glenoid fossa of about 3:1 with an appearance similar to a golf ball on a tee. Overall, there is minimal bony covering and limited contact areas that allow extensive translational and rotational ability in all three planes. The glenohumeral joint has 2 groups of stabilizers, which are static (passive) and dynamic (active) restrains. Static stabilizers include the concavity of the glenoid fossa, glenoid fossa retroversion and superior angulation, glenoid labrum, the joint capsule, and glenohumeral ligaments, and a vacuum effect from negative intra-articular pressure. Dynamic stabilization is merely the coordinated contraction of the rotator cuff muscles that create forces that compress the articular surfaces of the humeral head into the concave surface of the glenoid fossa. During upper extremity movement, the effects of static stabilizers are minimized and dynamic or active stabilizers become the dominant forces responsible for glenohumeral stability The simple act of arm elevation is a complex task that occurs via the combination of glenohumeral and scapulothoracic motion, together known as scapulohumeral rhythm. In the first 1200, glenohumeral arm abduction, the supraspinatus and deltoid work together and create a force couple that promotes stability, while raising the arm (deltoid contraction). In addition, the humerus must undergo 450 external rotation to not only clear the greater tuberosity posteriorly but also loosen the inferior glenohumeral ligament (IGHL) to allow maximum elevation. There are several anatomical updates regarding the rotator cuff and capsular footprint. The footprint of the supraspinatus on the greater tuberosity is much smaller than previously believed, and this area of the greater tuberosity is actually occupied by a substantial amount of the infraspinatus. The superior-most insertion of the subscapularis tendon extends a thin tendinous slip, which attaches to the fovea capitis of the humerus. The teres minor muscle inserts to the lowest impression of the greater tuberosity of the humerus and additionally inserts to the posterior side of the surgical neck of the humerus.

scholarly journals Baseball Pitchers’ Kinematic Sequences and Their Relationship to Elbow and Shoulder Torque Production

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0042
Author(s):  
Donna Moxley Scarborough ◽  
Shannon E. Linderman ◽  
Javier E. Sanchez ◽  
Eric M. Berkson
Keyword(s):  
Upper Extremity ◽  
External Rotation ◽  
Kinetic Chain ◽  
Joint Torques ◽  
Ball Velocity ◽  
Collegiate Baseball ◽  
Angular Velocities ◽  
Shoulder External Rotation ◽  
Baseball Pitchers ◽  
The Ideal

Objectives: Ball velocity is generated during the overhead baseball pitch via efficient force transmission up the kinetic chain, from the lower body up and outward to the throwing hand. The kinematic sequence, or the sequential timing pattern of peak angular velocities of body segments during a pitch, provides insight to segment position and motion control that drives the kinetic chain (Putnam CA, 1993). Previous publications report an ideal kinematic sequence (KS) where the timing of each body segment’s peak angular velocity occurs in a proximal-to-distal (PDS) pattern resulting in greater ball velocity and reduction in throwing arm injury risk (Fortenbaugh D, et.al, 2009). A recent study revealed that baseball pitchers perform a variety of KSs (Scarborough DM et.al, 2018). There is no known investigation of the relationship of kinematic sequences and throwing arm joint torques. The purpose of this study was to 1) identify the number of different KSs performed by each pitcher and 2) compare elbow valgus and shoulder external rotation (ER) and extension (Ext) torques between the 3 primary KSs performed during the fastball pitch. Methods: Fourteen collegiate baseball pitchers (20.57 ± 1.91 yr) underwent 3D biomechanical pitch analysis using 20 motion-capture Vicon MX™ cameras (360 Hz). A total of 119 fastball pitches with an average of 8.5 ± 2.71 pitches per player were analyzed. Elbow valgus and shoulder external rotation and extension torques were calculated. The timing of peak angular velocities for the pelvis, trunk, arm, forearm and hand body segments were recorded to generate each pitch’s KS. KSs were then divided into groups based on similarities to the ideal PDS pattern. ANCOVA statistical analyses were performed to compare joint torques across these KS groups with ball velocity as a covariate. Results: A total of 13 different KSs were observed across the 14 pitchers resulting in an average of 3 ± 1.41 different KSs per pitcher. Three different primary KS groups were identified: (1) PDS group: with a KS closest to the ideal PDS pattern (2) the Altered Distal Upper Extremity segment: with the forearm peaking after the hand (the most common group) and (3) Altered Proximal Upper Extremity segment order with the arm segment peaking after the hand (2nd most common). Across these three primary KS patterns, statistically significant differences were noted for elbow valgus torque [F(62,2) = 8.785, ɳ2 = .221, p < 0.00], shoulder external rotation (ER) torque [F(62,2) = 14.127, ɳ2 = .313, p < 0.00] and shoulder extension (Ext) torque [F(62,2) = 13.237, ɳ2 = .299, p < 0.00] (Figure 1). Conclusion: Our findings demonstrate that collegiate baseball pitchers performed an average of 3 different kinematic sequence patterns during fastball pitching. This is the first study to demonstrate a relationship between KSs and elbow and shoulder torque production. As anticipated, the PDS KSs produced the least torque across the elbow and shoulder joints. Alterations in Distal Upper Extremity KS was most common and generated the greatest shoulder Ext torques. Alterations in the Proximal Upper Extremity KS demonstrated the greatest elbow valgus and shoulder ER. Further study of the influence of kinematic sequence on joint torques in the baseball pitch may provide insight into pitching injuries and injury avoidance programs.

Biomechanical Analysis of Glenohumeral Internal Rotation Deficit in a Cadaveric Model

2010 ◽  
Author(s):  
Akash Gupta ◽  
Jeffrey Gates ◽  
Michelle H. McGarry ◽  
James E. Tibone ◽  
Thay Q. Lee
Keyword(s):  
Internal Rotation ◽  
Clinical Decision Making ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Clinical Decision ◽  
Biomechanical Analysis ◽  
Glenohumeral Internal Rotation Deficit ◽  
Posterior Translation ◽  
Throwers Shoulder ◽  
Cadaveric Model

Overhead throwing athletes have been shown to develop adaptive changes in humeral rotation to allow for higher throwing velocities. This manifests as an increase in humeral external rotation and a decrease in internal rotation, which is called glenohumeral internal rotation deficit (GIRD). The percentage of GIRD that significantly affects glenohumeral joint kinematics is not known. The objective of the study was to create a throwers shoulder model with fixed percentages of GIRD to determine at which point kinematic changes start occurring. The results showed that there was a significant decrease in posterior translation starting at 10% GIRD. With inferior translational loads, significantly less inferior translation starts occurring at 20% GIRD. The humeral head apex position at maximum external rotation moves superiorly, posteriorly and laterally, with significant changes in the superior direction occurring with 10% GIRD onwards. Overall, significant kinematic changes begin at 10% GIRD and this should be taken into account for clinical decision-making as to when intervention is necessary.

Three-Dimensional Scapular Kinematics during the Throwing Motion

2008 ◽  
Vol 24 (1) ◽  
pp. 24-34 ◽  
Author(s):  
Kristin E. Meyer ◽  
Erin E. Saether ◽  
Emily K. Soiney ◽  
Meegan S. Shebeck ◽  
Keith L. Paddock ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Angular Position ◽  
Three Dimensional ◽  
Low Velocity ◽  
Dynamic Activity ◽  
Motion Data ◽  
Asymptomatic Subjects ◽  
Scapular Motion

Proper scapular motion is crucial for normal shoulder mechanics. Scapular motion affects glenohumeral joint function during throwing, yet little is known about this dynamic activity. Asymptomatic subjects (10 male and 10 female), ages 21 to 45, were analyzed. Electromagnetic surface sensors on the sternum, acromion, and humerus were used to collect 3-D motion data during three trials of low-velocity throwing. Scapular angular position data were described for five predetermined events throughout the throw corresponding with classic descriptions of throwing phases, and trial-to-trial reliability was determined. ANOVA compared scapular angles across events. Subjects demonstrated good to excellent reliability between trials of the throw (ICC 0.74–0.98). The scapula demonstrated a pattern of external rotation, upward rotation (peak of approx. 40°), and posterior tilting during the initial phases of the throw, progressing into internal rotation after maximum humeral horizontal abduction. During the arm acceleration phase, the scapula moved toward greater internal rotation and began anteriorly tilting. At maximum humeral internal rotation, the scapula ended in internal rotation (55°), upward rotation (20°), and anterior tilting (3°).

Effect of Posterior Capsule Tightness on Glenohumeral Translation in the Late-Cocking Phase of Pitching

2007 ◽  
Vol 16 (1) ◽  
pp. 41-49 ◽  
Author(s):  
Kim M. Clabbers ◽  
John D. Kelly ◽  
Dov Bader ◽  
Matthew Eager ◽  
Carl Imhauser ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Humeral Head ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Head Position ◽  
Posterior Capsule ◽  
Nonsignificant Trend ◽  
Before And After ◽  
Fresh Frozen ◽  
Head Translation

Context:Throwing injuries.Objective:To study the effects of posterior capsule tightness on humeral head position in late cocking simulation.Design:Eight fresh frozen shoulders were placed in position of “late cocking,” 90 degrees abduction, and 10 degrees adduction and maximal external rotation. 3D measurements of humeral head relationship to the glenoid were taken with an infrared motion sensor, both before and after suture plication of the posterior capsule. Plications of 20% posterior/inferior capsule and 20% entire posterior capsule were performed, followed by plications of 40% of the posterior/inferior capsule and 40% entire posterior capsule.Setting:Cadaver Lab.Intervention:Posterior capsular placation.Main Outcome Measures:Humeral head position.Results:40%, but not 20%, posterior/inferior and posterior plications demonstrated a trend to increased posterior-superior humeral head translation relative to controls.Conclusion:Surgically created posterior capsular tightness of the glenohumeral joint demonstrated a nonsignificant trend to increased posterior/superior humeral head translation in the late cocking position of throwing.

scholarly journals Correlation of Shoulder and Elbow Kinetics With Ball Velocity in Collegiate Baseball Pitchers

2015 ◽  
Vol 50 (6) ◽  
pp. 629-633 ◽  
Author(s):  
Eric G. Post ◽  
Kevin G. Laudner ◽  
Todd A. McLoda ◽  
Regan Wong ◽  
Keith Meister
Keyword(s):  
External Rotation ◽  
Pearson Correlation ◽  
Anatomical Landmarks ◽  
Positive Correlation ◽  
Weak Positive Correlation ◽  
Ball Velocity ◽  
Collegiate Baseball ◽  
Shoulder External Rotation ◽  
Baseball Pitchers ◽  
Distraction Force

Context Throwing a baseball is a dynamic and violent act that places large magnitudes of stress on the shoulder and elbow. Specific injuries at the elbow and glenohumeral joints have been linked to several kinetic variables throughout the throwing motion. However, very little research has directly examined the relationship between these kinetic variables and ball velocity. Objective To examine the correlation of peak ball velocity with elbow-valgus torque, shoulder external-rotation torque, and shoulder-distraction force in a group of collegiate baseball pitchers. Design Cross-sectional study. Setting Motion-analysis laboratory. Patients or Other Participants Sixty-seven asymptomatic National Collegiate Athletic Association Division I baseball pitchers (age = 19.5 ± 1.2 years, height = 186.2 ± 5.7 cm, mass = 86.7 ± 7.0 kg; 48 right handed, 19 left handed). Main Outcome Measure(s) We measured peak ball velocity using a radar gun and shoulder and elbow kinetics of the throwing arm using 8 electronically synchronized, high-speed digital cameras. We placed 26 reflective markers on anatomical landmarks of each participant to track 3-dimensional coordinate data. The average data from the 3 highest-velocity fastballs thrown for strikes were used for data analysis. We calculated a Pearson correlation coefficient to determine the associations between ball velocity and peak elbow-valgus torque, shoulder-distraction force, and shoulder external-rotation torque (P &lt; .05). Results A weak positive correlation was found between ball velocity and shoulder-distraction force (r = 0.257; 95% confidence interval [CI] = 0.02, 0.47; r2 = 0.066; P = .018). However, no significant correlations were noted between ball velocity and elbow-valgus torque (r = 0.199; 95% CI = −0.043, 0.419; r2 = 0.040; P = .053) or shoulder external-rotation torque (r = 0.097; 95% CI = −0.147, 0.329; r2 = 0.009; P = .217). Conclusions Although a weak positive correlation was present between ball velocity and shoulder-distraction force, no significant association was seen between ball velocity and elbow-valgus torque or shoulder external-rotation torque. Therefore, other factors, such as improper pitching mechanics, may contribute more to increases in joint kinetics than peak ball velocity.

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