The disabled throwing shoulder: Spectrum of pathology part I: Pathoanatomy and biomechanics

Burkhart, Stephen S.; Morgan, Craig D.; Kibler, W. Ben

doi:10.1053/jars.2003.50128

Cited by 1,115 publications

(1,111 citation statements)

References 38 publications

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“…We founded a significant posteroinferior capsule tightness in the dominant shoulder of PG, when compared to the dominant shoulder of CG and nondominant shoulder in both groups. Previous studies showed the deleterious effects of the posteroinferior capsule tightness, like Burkhart et al 33 , hypothesizing that the posterior shoulder capsule leads to a posteriorsuperior shift in the humeral head during the latecocking phase of throwing. In the late-cocking phase, the biceps vector shifts posteriorly and twists at its base, maximizing peel-back forces and predisposing SLAP lesions.…”

Section: Discussionmentioning

confidence: 93%

Posterior shoulder tightness and rotator cuff strength assessments in painful shoulders of amateur tennis players

Marcondes¹,

Jesus²,

Bryk³

et al. 2013

Braz. J. Phys. Ther.

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| Background: Previous studies have shown a relationship between shoulder posterior capsule tightness and shoulder pain in overhead athletes. However, this relationship has not been studied in tennis players. Objectives: Assessment of the shoulder range of motion (ROM), strength and posterior capsule tightness of skilled amateur tennis players who had complaints of dominant shoulder pain in comparison with tennis players without pain. Method: Fortynine skilled amateur tennis players were distributed in 2 groups: Control Group (n=22) and Painful Group (n=27). The first group was composed of asymptomatic subjects, and the second was composed of subjects with shoulder pain on the dominant side. These groups were evaluated to determine the dominant and non-dominant shoulder ROM (internal and external rotation), isometric shoulder strength (internal and external rotation) and posterior shoulder tightness by blind evaluators. Results: The ANOVA results indicated significant differences between the groups in the dominant shoulder ROM, posterior capsule tightness, external rotation strength and strength ratio (p<0.05). The intragroup analysis (dominant versus non-dominant) in the Painful Group displayed a significant difference for ROM, posterior capsule tightness and external rotation strength (p<0.05). Conclusions: The tennis players with pain in the dominant shoulder presented greater posterior capsule tightness, internal rotation deficit (ROM), external rotation gain (ROM) and deficits in external rotation strength than the tennis players without pain.Keywords:physical therapy; rehabilitation; tennis; rotator cuff; Shoulder Impingement Syndrome. HOW TO CITE THIS ARTICLEMarcondes FB, Jesus JF, Bryk FF, Vasconcelos RA, Fukuda TY. Posterior shoulder tightness and rotator cuff strength assessments in painful shoulders of amateur tennis players. Braz J Phys Ther.

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Section: Discussionmentioning

confidence: 93%

Posterior shoulder tightness and rotator cuff strength assessments in painful shoulders of amateur tennis players

Marcondes¹,

Jesus²,

Bryk³

et al. 2013

Braz. J. Phys. Ther.

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“…The cause of the pain is controversial [5,9,14,18]. Kvitne and Jobe [9] suggested the pain is a consequence of a subtle anterior instability while Burkhart et al [5] believed the pain is the result of hypertwisting of the rotator cuff fibers with hyperexternal rotation.…”

Section: Introductionmentioning

confidence: 99%

“…Kvitne and Jobe [9] suggested the pain is a consequence of a subtle anterior instability while Burkhart et al [5] believed the pain is the result of hypertwisting of the rotator cuff fibers with hyperexternal rotation. We suspect mechanical impingement of the tendinous cuff insertion on the glenoid rim creates tendon lesions, which are the cause of the pain.…”

Section: Introductionmentioning

confidence: 99%

Surgical Technique Arthroscopic Posterior Glenoidplasty for Posterosuperior Glenoid Impingement in Throwing Athletes

Lévigne¹,

Garret²,

Grosclaude³

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Posterosuperior glenoid impingement (PSGI) is the repetitive impaction of the supraspinatus tendon insertion on the posterosuperior glenoid rim in abduction and external rotation. While we presume the pain is mainly caused by mechanical impingement, this explanation is controversial. If nonoperative treatment fails, arthroscopic débridement of tendinous and labral lesions has been proposed but reportedly does not allow a high rate of return to sports. In 1996, we proposed adding abrasion of the bony posterior rim, or glenoidplasty.

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“…Some believe increases in external rotation occur over several years and are associated with the repetitive stretching of the anterior capsule [9,10,22,27,28]. Based on surgical observations, others have suggested the internal rotation deficits are a result of an acquired hypertrophied posterior capsule [5,6,31,39]. It is thought that a thicker posterior capsule would have increased structural stiffness, thereby limiting internal rotation [5,6,31,39].…”

Section: Introductionmentioning

confidence: 99%

“…Based on surgical observations, others have suggested the internal rotation deficits are a result of an acquired hypertrophied posterior capsule [5,6,31,39]. It is thought that a thicker posterior capsule would have increased structural stiffness, thereby limiting internal rotation [5,6,31,39]. Finally, others believe both are caused by an increase of humeral retroversion [8,32,33,35].…”

Section: Introductionmentioning

confidence: 99%

Internal Rotation Deficits Affect Scapular Positioning in Baseball Players

Thomas

Swanik

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Anecdotal evidence suggests an association between glenohumeral internal rotation deficits (GIRD) and scapular dysfunction, an observable alteration in the normal position or motion of the scapula in relation to the thoracic cage. Questions/purposes We therefore hypothesized players with GIRD (15°or greater) will have decreased dominant arm scapular upward rotation and increased scapular protraction compared with baseball players with GIRD (14°or less). Methods We studied 43 baseball players with no current shoulder or elbow symptoms; 22 had GIRD 15°or greater and 21 had GIRD 14°or less. We measured glenohumeral internal rotation supine with the scapula stabilized. Scapular upward rotation was tested at rest; 60°, 90°, and 120°a bduction in the scapular plane; and scapular protraction at 0°, hands on hips, and 90°abduction in the scapular plane.

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The disabled throwing shoulder: Spectrum of pathology part I: Pathoanatomy and biomechanics

Cited by 1,115 publications

References 38 publications

Posterior shoulder tightness and rotator cuff strength assessments in painful shoulders of amateur tennis players

Posterior shoulder tightness and rotator cuff strength assessments in painful shoulders of amateur tennis players

Surgical Technique Arthroscopic Posterior Glenoidplasty for Posterosuperior Glenoid Impingement in Throwing Athletes

Internal Rotation Deficits Affect Scapular Positioning in Baseball Players

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