Scapular Resting Position and Gleno-Humeral Movement Dysfunction in Asymptomatic Racquet Players: A Case-Control Study

Abstract

Background:Racquet sports, especially lawn tennis and badminton have been gaining popularity in Asian countries like India. With this increase in popularity, the injury rate in the sport has also increased.Objectives:The study will help detect the presence of gleno-humeral movement dysfunction and scapular resting position abnormality in asymptomatic racquet players, thus providing basis for screening the players and allow the clinician to determine if the asymmetry is a normal adaptation in the player or an abnormal change associated with injury.Materials and Methods:46 asymptomatic professional players were divided into a study group of 23 players (16 tennis and 7 badminton) and control group of 23 football players. Assessment of passive gleno-humeral range of motion and distance of spine and inferior angle of scapula from corresponding spinous process were measured bilaterally and between groups.Results:There was statistically significant reduction in range of internal rotation (62.17 ± 8.09), extension (39.78 ± 4.12) and an increase in the external rotation (106.95 ± 7.49) of dominant compared to non-dominant arm of racquet players and a statistically significant decrease in internal rotation (78.69 ± 10.24), extension (44.78 ± 3.19), adduction (37.39 ± 6.54) and an increase in external rotation (102.6 ± 5.19) of dominant arm of racquet players compared to football players. Study also showed statistically significant increase in the spino-scapular distance at the level of inferior angle of scapula (10.23 ± 1.43) on dominant side compared to non-dominant.Conclusions:The dominant side scapula of asymptomatic racquet players showed increased external rotation and elevation as compared to the non-dominant side. Also, reduced shoulder internal rotation, extension and adduction and gain in shoulder external rotation was observed on the dominant side of racquet players when compared to the control group.

Assessment of upper extremity stability, GIRD (Glenohumeral internal rotation deficit)/GERG (Glenohumeral external rotation gain) ratio and strength of internal rotators (IR) and external rotators (ER) in badminton players

“…Results of the present study also show significant reduction in the internal rotation and extension ROM and a gain in the external rotation of the dominant shoulder compared to the non-dominant shoulder of racquet players [7] . Also, there was a significant reduction in internal rotation, extension and adduction and an increase in external rotation of the dominant shoulder of racquet players when compared to dominant shoulder of non-racquet players [7] . During the follow through phase of an overhead motion, the shoulder joint is subjected to distractive forces of up to 750N which is mainly resisted by the postero-inferior capsule [15,37] .…”

“…Table no. 7 shows the correlation between the CKCUEST and the dominant side external rotators with an extremely significant p value of 0.0002 and Spearman r of 0.6741. Table no.…”

“…Racquet sports, especially lawn tennis and badminton have been gaining popularity in Asian countries like India. With this increase in popularity, the injury rate in the sport has also increased [7] . Sports that involve repetitive overarm motions like baseball, badminton, and tennis require well co-ordinated and synchronized actions of the shoulder muscles, in particular, the rotators [8] .…”

Bilateral Comparison of Anterior Shoulder Position in Elite Tennis Players

“…3,4 Clinical assessment of the shoulder and scapular positioning for unilateral overhead athletes often reveals asymmetry between the dominant and non-dominant sides. [5][6][7][8][9][10][11][12] It has been well established that overhead athletes regularly have increased external rotation and corresponding decreases in internal rotation range of motion of the dominant shoulder compared to their non-dominant shoulder. 9,13 In addition, when both internal rotation and the total arc of rotation between shoulders is asymmetrical, it has been associated with an increased risk of injuries in overhead athletes.…”

“…Various methods to quantify scapular position asymmetries in athletes have been published, [5][6][7][8][9][10][11][12][13]19,20,[25][26][27][28][29] Kibler has highlighted the association between scapular dyskinesis and overuse injury in tennis players and in overhead athletes in general. 21,27,[30][31][32] Kibler has developed a method for evaluating and classifying scapular pathology using visual observation during movement and static positioning.…”