Three-Dimensional Upper Body Kinematics and Inter-articular Kinematic Sequence During a Canoe Polo Throw

Canoe polo is an increasingly popular discipline requiring both kayaking and ball-handling skills. While the kinematics of the upper body during throw has been investigated for several overhead sports, the canoe polo throw has still to be studied. Therefore, the aim of this study is to analyze the canoe polo throw kinematics in terms of angles and inter-articular sequencing to understand its specificity. A secondary aim was to investigate whether adding pelvis mobility has an impact. Nineteen male players of canoe polo were equipped with reflective body markers for the throw analysis. They performed 5 throws with the pelvis fixed and 5 throws with additional pelvic mobility in rotation around a vertical axis. Inverse kinematics was performed with OpenSim providing pelvis, trunk, and glenohumeral rotations. Angular velocities were calculated to build the inter-articular sequences relative to these throws. Statistical parametric mapping was used to assess the effect of pelvis mobility on the throwing kinematics. Similar kinematics patterns as in other overhead sports were observed, however, a different inter-articular sequence was found for the canoe polo throw with a maximal angular velocity occurring sooner for the thorax in axial rotation than for the pelvis in rotation. While the limitation of rotation of the pelvis around a vertical axis has an influence on the pelvis and trunk kinematics, it did not modify the kinematic sequence.

Isolated infraspinatus atrophy in elite volleyball player- Understanding the biomechanics, imaging and outcome

Over 800 million people worldwide play volleyball, either recreational or competitive. Even though all throwing athletes suffer from upper extremity injuries caused by overuse, volleyball additionally involves certain prototypical throwing biomechanics, not seen in other overhead sports. Complex biomechanics and the balanced interplay between the glenohumeral and scapulothoracic muscles ensure velocity and torque displacement in spike and jump-serve maneuvers (formerly known as smash) which are exclusive to volleyball. In this case report, we have described in detail the entity of isolated infraspinatus atrophy secondary to suprascapular nerve neuropathy.

Strength training for throwing velocity enhancement in overhead throw: A systematic review and meta-analysis

The overhead throw is a fundamental technical-tactical ability for overhead sports. The purposes of this review are to assess the effect of resistance training (RT) in enhancing throwing velocity in athletes and to investigate the relationships between age or gender in this effect. Control group trials were identified through looking up electronic databases with a search span of 10th December 2020. Only studies which have control groups within research design, subjects randomly assigned to groups, healthy athletes with experience in the sport, an intervention consisting of a supervised RT program of a minimum duration of 4 weeks, and assessment of sport-specific throwing velocity were taken into account for this meta-analysis. A total of 16 studies with 424 subjects were deemed eligible per the inclusion criteria. The overall pooled analysis demonstrated that a large effect was observed for throwing velocity outcomes (ES 1.10; 95% CI 0.64–1.57; p < 0.00001). Differences were due to gender, with male (ES 1.12; 95% CI 0.55–1.78; p < 0.0001) and female athletes (ES 1.22; 95% CI 0.25–2.20; p < 0.00001). And due to age, with teenager athletes (ES 0.49; 95% CI -0.18–1.17; p = 0.04) and adult athletes (ES 1.34; 95% CI 0.64–1.92; p < 0.00001). Throwing velocity enhancement after RT was greater for women than for men, and for adults more than underage subjects. RT should last at least four weeks, with 2–3 sessions each week, and with any available implement.

Evaluation of glenohumeral range of motion and humeral retroversion at ages after major change and differences in wrestlers

Purpose: This study aimed to present the change in humeral retroversion (HR) angle (HRA) that occurs in childhood and young adulthood and the potential developmental difference that is observed in wrestlers. Methods: HRA of dominant and non-dominant shoulders (DSHRA and NDSHRA, respectively) were measured using ultrasonography in a group of 30 wrestlers who started wrestling before the age of 13 years (Group 1), a group of 30 young adults, aged between 16–20 years, who were not actively engaged in any branch of overhead sports (Group 2) and a group of children aged between 11–13 years and not actively engaged in any branch of overhead sports (Group 3). Range of motion (ROM) degrees of dominant and non-dominant shoulders in all groups were compared within each group and between the groups. Results: DSHRA (mean: 88.73°, 88.93° and 89.40°) values were significantly higher than NDSHRA (mean: 81.13°, 81.83° and 84.37°) values (p < 0.001, p < 0.001 and p < 0,05) in Groups I, II and III, respectively. Internal rotation and total ROM degrees of the dominant shoulder in Group 1 and 3 were higher than those in Group 2. Conclusion: There is no significant change in terms of HRA in people aged between 11–13 and 16–20 years because of natural development or wrestling. DSHRA values are higher than NDSHRA ones. In contrast to the shoulders of throwers, the shoulders of wrestlers are characterized by an increase in internal rotation, described as “Wrestler’s shoulder.” Level of Evidence: Level III.

Scapular Kinematics in Athletes With and Without Rotator Cuff Tendinopathy: A Systematic Review

Context: Rotator cuff tendinopathy is one of the most frequently reported shoulder injuries in athletes of overhead sports. Abnormal scapular kinematics has been proposed as one of the contributing factors of rotator cuff tendinopathy in overhead athletes. Objectives: To review the literature on 3-dimensional scapular kinematics in overhead athletes with and without rotator cuff tendinopathy. Evidence Acquisition: Electronic databases (Cochrane Library, MEDLINE, Embase, and PubMed) were searched from inception to September 2017. In addition, the reference lists of the articles that met the inclusion criteria were also searched. We included studies that compared the changes in 3-dimensional scapular kinematics in athletes with and without rotator cuff tendinopathy. Two reviewers independently examined the quality of studies by using the modified Downs and Black checklist. Evidence Synthesis: A total of 9 studies (a total of 332 athletes, mean age 23.41 [2.62] y) were included in the final analysis. The methodological quality was low (modified Downs and Black checklist = 9/15). Our findings showed a consistent pattern of increased scapular anterior tilting and internal rotation in the dominant shoulders than the nondominant shoulders of athletes who participated in overhead sports. Athletes of overhead sports seem to demonstrate an increase in scapular upward rotation during arm elevation when compared with nonathlete individuals. However, there is no consensus on the scapular kinematics pattern in athletes with rotator cuff tendinopathy when compared with healthy controls. Conclusion: Findings demonstrated that changes in scapular kinematics were observed in overhead athletes. However, all the included studies were cross-sectional studies with small sample size and diverse sports participation, whether changes in scapular kinematics may contribute to rotator cuff tendinopathy in overhead athletes warrants more high-quality prospective studies.

Are Patients Who Undergo the Latarjet Procedure Ready to Return to Play at 6 Months? A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Group Cohort Study

Background: The Latarjet procedure is growing in popularity for treating athletes with recurrent anterior shoulder instability, largely because of the high recurrence rate of arthroscopic stabilization, particularly among contact athletes with bone loss. Purpose: (1) To evaluate return of strength and range of motion (ROM) 6 months after the Latarjet procedure and (2) to determine risk factors for failure to achieve return-to-play (RTP) criteria at 6 months. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 65 athletes (83% contact sports, 37% overhead sports; mean ± SD age, 24.5 ± 8.2 years; 59 male, 6 female) who enrolled in a prospective multicenter study underwent the Latarjet procedure for anterior instability (29% as primary procedure for instability, 71% for failed prior stabilization procedure). Strength and ROM were assessed preoperatively and 6 months after surgery. RTP criteria were defined as return to baseline strength and <20° side-to-side ROM deficits in all planes. The independent likelihood of achieving strength and motion RTP criteria at 6 months was assessed through multivariate logistic regression modeling with adjustment as needed for age, sex, subscapularis split versus tenotomy, preoperative strength/motion, percentage bone loss, number of prior dislocations, preoperative subjective shoulder function (American Shoulder and Elbow Surgeons and Western Ontario Shoulder Instability Index percentage), and participation in contact versus overhead sports. Results: Of the patients, 55% failed to meet ≥1 RTP criteria: 6% failed for persistent weakness and 51% for ≥20° side-to-side loss of motion. There was no difference in failure to achieve RTP criteria at 6 months between subscapularis split (57%) versus tenotomy (47%) ( P = .49). Independent risk factors for failure to achieve either strength or ROM criteria were preoperative American Shoulder and Elbow Surgeons scores (per 10-point decrease: adjusted odds ratio [aOR], 1.61; 95% CI, 1.14-2.43; P = .006), Western Ontario Shoulder Instability Index percentage (per 10% decrease: aOR, 0.61; 95% CI, 0.38-0.92; P = .01), and a preoperative side-to-side ROM deficit ≥20° in any plane (aOR, 5.01; 95% CI, 1.42-21.5; P = .01) or deficits in external rotation at 90° of abduction (per 10° increased deficit: aOR, 1.64; 95% CI, 1.06-2.88; P = .02). Conclusion: A large percentage of athletes fail to achieve full strength and ROM 6 months after the Latarjet procedure. Greater preoperative stiffness and subjective disability are risk factors for failure to meet ROM or strength RTP criteria.

Is Return To Play At 6 Months After Latarjet Safe? A Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Group Cohort Study

Objectives: The Latarjet procedure is the becoming increasingly popular for the treatment of young athletes with recurrent instability. Earlier return to play protocols have been trialed with the thought that one is primarily waiting on bone healing. However, the impact of post-operative range of motion (ROM) and strength must be considered as well. Return to play has traditionally been accepted at 6 months post-operatively, but it is unknown what percentage of athletes achieve full strength and range of motion at that point. The purpose of this study was to 1) To evaluate rates of return of full strength and range of motion at 6 months after Latarjet, and 2) determine whether rates of results vary by percent bone loss, subscapularis split versus tenotomy, or athlete status (contact or overhead). Methods: Ten participating sites throughout the United States enrolled patients in a multicenter prospective cohort study. Sixty-five athletes met inclusion criteria (mean age 24.5 SD 8.2; 59 male, 6 female) and underwent Latarjet procedure for anterior instability (19/65 (29%) primary operation, 46/65 (71%) had a prior failed anterior stabilization). All participated in either contact sports (83%) and/or overhead sports (37%). Regarding anterior glenoid bone loss, 10% had <10% bone loss, 55% had 11-20%, and 35% had 21-30%. The Latarjet procedure was performed with either subscapularis tenotomy (64%) or split (36%). Strength and range of motion were assessed pre-operatively and at 6 months after surgery. Return to play (RTP) criteria were defined as full strength as well as less than 20 degrees side-to-side ROM deficits in all planes. The independent likelihood of strength and motion RTP criteria at 6 months for percent bone loss as well as subscapularis tenotomy vs split was assessed with multivariate logistic regression modeling with adjustment as needed for age, sex, preoperative strength/motion, number of prior dislocations, and participation in contact versus overhead sports. Results: 45% of patients failed to meet one or more return to play criteria: 9% failed for persistent weakness and 39% for ≥ 20 degree side to side loss of motion. All patients with loss of motion had ≥ 20 degree external rotation (ER) deficits either with elbow at side (88%) or at 90 degrees abduction (44%). There was no difference in achieving RTP criteria at 6 months between subscapularis split versus tenotomy either for strength (p=0.89) or range of motion (p=0.53). Contact athletes had a 53% RTP rate while overhead athletes had a 67% passage rate (p=0.17). Pre-operative weakness was not significantly predictive of post-operative weakness (p=0.13), and pre-operative external rotation was not predictive of post-operative ER deficits (p=0.16). Percent bone loss was not predictive of side-to side post-operative ROM deficits or weakness (p>0.20 all planes of motion). No other predictors for failure to meet RTP criteria at 6 months were identified. Conclusion: A large percentage of athletes do not have full return of strength and range of motion at 6 months following Latarjet procedure. Further consideration may be warranted prior to releasing these athletes to contact sports.