The Mature Athlete’s Shoulder

Tokish, John M.

doi:10.1177/1941738113514344

Cited by 5 publications

(5 citation statements)

References 54 publications

(86 reference statements)

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“…Rotator cuff (RTC) tears, particularly in the supraspinatus muscle, are a common orthopedic problem resulting in shoulder dysfunction and can result in disability [ 17 , 41 , 73 , 76 ]. Despite substantial biologic tendon healing after a RTC repair, persistent problems include high re-tear rates and long-term functional deficits of the muscle-tendon unit that may persist even in the absence of a recurrent tendon tear [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Impaired contractile function of the supraspinatus in the acute period following a rotator cuff tear

Valencia

Iyer

Spangenburg

et al. 2017

BMC Musculoskelet Disord

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BackgroundRotator cuff (RTC) tears are a common clinical problem resulting in adverse changes to the muscle, but there is limited information comparing histopathology to contractile function. This study assessed supraspinatus force and susceptibility to injury in the rat model of RTC tear, and compared these functional changes to histopathology of the muscle.MethodsUnilateral RTC tears were induced in male rats via tenotomy of the supraspinatus and infraspinatus. Maximal tetanic force and susceptibility to injury of the supraspinatus muscle were measured in vivo at day 2 and day 15 after tenotomy. Supraspinatus muscles were weighed and harvested for histologic analysis of the neuromuscular junction (NMJ), intramuscular lipid, and collagen.ResultsTenotomy resulted in eventual atrophy and weakness. Despite no loss in muscle mass at day 2 there was a 30% reduction in contractile force, and a decrease in NMJ continuity and size. Reduced force persisted at day 15, a time point when muscle atrophy was evident but NMJ morphology was restored. At day 15, torn muscles had decreased collagen-packing density and were also more susceptible to contraction-induced injury.ConclusionMuscle size and histopathology are not direct indicators of overall RTC contractile health. Changes in NMJ morphology and collagen organization were associated with changes in contractile function and thus may play a role in response to injury. Although our findings are limited to the acute phase after a RTC tear, the most salient finding is that RTC tenotomy results in increased susceptibility to injury of the supraspinatus.

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Section: Introductionmentioning

confidence: 99%

Impaired contractile function of the supraspinatus in the acute period following a rotator cuff tear

Valencia

Iyer

Spangenburg

et al. 2017

BMC Musculoskelet Disord

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“…The majority of full-thickness RTC tears present in patients over 50 years of age (12,81). Chronic tears can lead to fatty degeneration of the muscle, which is a poor prognostic factor for healing (45,79).…”

Section: Discussionmentioning

confidence: 99%

“…Thus the surrounding rotator cuff (RTC) muscles not only generate movement, but also provide important joint stability. RTC tears, particularly in the supraspinatus muscle, are a common problem encountered in orthopedics (12,81). Large RTC tears can lead to irreversible muscle atrophy and fatty infiltration, especially in older patients (26,38).…”

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confidence: 99%

A method to test contractility of the supraspinatus muscle in mouse, rat, and rabbit

Valencia

Iyer

Pratt

et al. 2016

Journal of Applied Physiology

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The rotator cuff (RTC) muscles not only generate movement but also provide important shoulder joint stability. RTC tears, particularly in the supraspinatus muscle, are a common clinical problem. Despite some biological healing after RTC repair, persistent problems include poor functional outcomes with high retear rates after surgical repair. Animal models allow further exploration of the sequela of RTC injury such as fibrosis, inflammation, and fatty infiltration, but there are few options regarding contractility for mouse, rat, and rabbit. Histological findings can provide a "direct measure" of damage, but the most comprehensive measure of the overall health of the muscle is contractile force. However, information regarding normal supraspinatus size and contractile function is scarce. Animal models provide the means to compare muscle histology, imaging, and contractility within individual muscles in various models of injury and disease, but to date, most testing of animal contractile force has been limited primarily to hindlimb muscles. Here, we describe an in vivo method to assess contractility of the supraspinatus muscle and describe differences in methods and representative outcomes for mouse, rat, and rabbit.

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“…Repetitive, abnormal loading leads to the destruction of the articular surface of the humeral head and glenoid 9,10 . In addition, shoulder injuries are increasingly common in high school and college sports, as well as in the mature athlete, leading to earlier development of GH arthritis because of prolonged abnormal wear of the shoulder girdle 11,12 .…”

Section: Clinical Presentation Historymentioning

confidence: 99%

“…A normal natural history of the shoulder includes stiffness, rotator cuff tears, instability, and osteoarthritis, all of which can become increasingly more symptomatic as an athlete ages 12 . In a US population of patients younger than 40 years with anterior shoulder instability, approximately one-fourth developed symptomatic arthritis at a mean follow-up of 15 years from their first instability event 13 .…”

Section: Clinical Presentation Historymentioning

confidence: 99%

Diagnosis and Management of Glenohumeral Arthritis in the Active Adult

Garvick

Bates

Jensen

et al. 2022

JBJS Journal of Orthopaedics for Physician Assistants

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Glenohumeral arthritis can significantly impact quality of life, most notable in highly active patients. A linear approach to management based on age alone negates factors that impact patient goals such as pain control, joint function, and joint preservation. Diagnostics should use X-ray, computed tomography, and magnetic resonance imaging to provide information about severity of disease and inform treatment plans, including surgical approaches. Although surgical intervention in young adults has previously been controversial, after nonoperative interventions, such as medications, physical therapy, and intra-articular injections, have failed, many studies support arthroplasty to control pain and maximize function throughout their life span.

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The Mature Athlete’s Shoulder

Cited by 5 publications

References 54 publications

Impaired contractile function of the supraspinatus in the acute period following a rotator cuff tear

Impaired contractile function of the supraspinatus in the acute period following a rotator cuff tear

A method to test contractility of the supraspinatus muscle in mouse, rat, and rabbit

Diagnosis and Management of Glenohumeral Arthritis in the Active Adult

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