Physical Therapy Korea (한국전문물리치료학회지)

Korean Research Society of Physical Therapy (한국전문물리치료학회)
권호 표지
DOI QR코드

DOI QR Code

Comparison of Rotator Cuff Muscle Strength With and Without Scapular Dyskinesis in Adolescent Baseball Players

  • Il-young Yu (Department of Smart Healthcare, College of Information Convergence, Pukyong National University) ;
  • Tae-gyu Kim (Department of Smart Healthcare, College of Information Convergence, Pukyong National University)
  • Received : 2024.04.03
  • Accepted : 2024.05.27
  • Published : 2024.08.20
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Scapular dyskinesis (SD) is closely related to imbalance of the rotator cuff (RC) muscles. However, previous studies have only focused on isometric strength. To our knowledge, there has been no study examining potential differences in concentric and eccentric strength and functional strength ratio (FSR) of the RC muscles based on functional parameters related to throwing in with or without SD. Objects: This study aimed to determine whether there was a difference in the RC muscle strength and FSR between the dominant shoulder with SD and the non-dominant shoulder without SD in adolescent baseball players. Methods: Forty adolescent baseball players participated and classified types of SD based on movement patterns using the SD test by two examiners. The isokinetic concentric and eccentric peak torque of the internal rotation (IR) and external rotation (ER) were measured and quantified as peak torque to body weight (PT/BW). Also, the FSR was obtained by calculating the strength ratios of eccentric IR to concentric ER (IRecc/ERcon) and eccentric ER to concentric IR (ERecc/IRcon), respectively. Results: There was a significant decrease in the IR and ER PT/BW in the dominant shoulder with SD compared to the non-dominant shoulder without SD (p < 0.05), regardless of contraction types. However, no significant difference was observed in the FSR in both IRecc/ERcon and ERecc/IRcon ratios. Conclusion: The findings indicate that the isokinetic concentric and eccentric PT/BW of the IR and ER muscles were significantly lower in the dominant shoulder with SD than in the nonthrowing shoulder without SD. Therefore, when establishing a strategy for addressing RC muscle weakness in adolescent baseball players with SD, it is essential to consider an approach that accounts for scapular kinematic recovery.

Keywords

References

  1. Jobe FW, Pink M. Classification and treatment of shoulder dysfunction in the overhead athlete. J Orthop Sports Phys Ther 1993;18(2):427-32.  https://doi.org/10.2519/jospt.1993.18.2.427
  2. Meister K. Injuries to the shoulder in the throwing athlete. Part one: biomechanics/pathophysiology/classification of injury. Am J Sports Med 2000;28(2):265-75.  https://doi.org/10.1177/03635465000280022301
  3. Lyman S, Fleisig GS, Andrews JR, Osinski ED. Effect of pitch type, pitch count, and pitching mechanics on risk of elbow and shoulder pain in youth baseball pitchers. Am J Sports Med 2002;30(4):463-8.  https://doi.org/10.1177/03635465020300040201
  4. Rechel JA, Yard EE, Comstock RD. An epidemiologic comparison of high school sports injuries sustained in practice and competition. J Athl Train 2008;43(2):197-204.  https://doi.org/10.4085/1062-6050-43.2.197
  5. Fleisig GS, Bolt B, Fortenbaugh D, Wilk KE, Andrews JR. Biomechanical comparison of baseball pitching and long-toss: implications for training and rehabilitation. J Orthop Sports Phys Ther 2011;41(5):296-303.  https://doi.org/10.2519/jospt.2011.3568
  6. Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology Part III: the SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation. Arthroscopy 2003;19(6):641-61.  https://doi.org/10.1016/S0749-8063(03)00389-X
  7. Wilk KE, Meister K, Andrews JR. Current concepts in the rehabilitation of the overhead throwing athlete. Am J Sports Med 2002;30(1):136-51.  https://doi.org/10.1177/03635465020300011201
  8. Digiovine NM, Jobe FW, Pink M, Perry J. An electromyographic analysis of the upper extremity in pitching. J Shoulder Elbow Surg 1992;1(1):15-25.  https://doi.org/10.1016/S1058-2746(09)80011-6
  9. Clarsen B, Bahr R, Andersson SH, Munk R, Myklebust G. Reduced glenohumeral rotation, external rotation weakness and scapular dyskinesis are risk factors for shoulder injuries among elite male handball players: a prospective cohort study. Br J Sports Med 2014;48(17):1327-33.  https://doi.org/10.1136/bjsports-2014-093702
  10. Mullaney MJ, McHugh MP, Donofrio TM, Nicholas SJ. Upper and lower extremity muscle fatigue after a baseball pitching performance. Am J Sports Med 2005;33(1):108-13.  https://doi.org/10.1177/0363546504266071
  11. Wilk KE, Andrews JR, Arrigo CA, Keirns MA, Erber DJ. The strength characteristics of internal and external rotator muscles in professional baseball pitchers. Am J Sports Med 1993;21(1):61-6.  https://doi.org/10.1177/036354659302100111
  12. Kibler WB, Ludewig PM, McClure PW, Michener LA, Bak K, Sciascia AD. Clinical implications of scapular dyskinesis in shoulder injury: the 2013 consensus statement from the 'scapular summit'. Br J Sports Med 2013;47(14):877-85.  https://doi.org/10.1136/bjsports-2013-092425
  13. Edouard P, Degache F, Oullion R, Plessis JY, Gleizes-Cervera S, Calmels P. Shoulder strength imbalances as injury risk in handball. Int J Sports Med 2013;34(7):654-60.  https://doi.org/10.1055/s-0032-1312587
  14. Trakis JE, McHugh MP, Caracciolo PA, Busciacco L, Mullaney M, Nicholas SJ. Muscle strength and range of motion in adolescent pitchers with throwing-related pain: implications for injury prevention. Am J Sports Med 2008;36(11):2173-8.  https://doi.org/10.1177/0363546508319049
  15. Smith J, Dietrich CT, Kotajarvi BR, Kaufman KR. The effect of scapular protraction on isometric shoulder rotation strength in normal subjects. J Shoulder Elbow Surg 2006;15(3):339-43.  https://doi.org/10.1016/j.jse.2005.08.023
  16. Kibler WB. The role of the scapula in athletic shoulder function. Am J Sports Med 1998;26(2):325-37.  https://doi.org/10.1177/03635465980260022801
  17. Kibler WB, Sciascia A, Dome D. Evaluation of apparent and absolute supraspinatus strength in patients with shoulder injury using the scapular retraction test. Am J Sports Med 2006;34(10):1643-7.  https://doi.org/10.1177/0363546506288728
  18. Kebaetse M, McClure P, Pratt NA. Thoracic position effect on shoulder range of motion, strength, and three-dimensional scapular kinematics. Arch Phys Med Rehabil 1999;80(8):945-50.  https://doi.org/10.1016/S0003-9993(99)90088-6
  19. Merolla G, De Santis E, Campi F, Paladini P, Porcellini G. Infraspinatus scapular retraction test: a reliable and practical method to assess infraspinatus strength in overhead athletes with scapular dyskinesis. J Orthop Traumatol 2010;11(2):105-10.  https://doi.org/10.1007/s10195-010-0095-x
  20. Merolla G, De Santis E, Campi F, Paladini P, Porcellini G. Supraspinatus and infraspinatus weakness in overhead athletes with scapular dyskinesis: strength assessment before and after restoration of scapular musculature balance. Musculoskelet Surg 2010;94(3):119-25.  https://doi.org/10.1007/s12306-010-0082-7
  21. Merolla G, De Santis E, Sperling JW, Campi F, Paladini P, Porcellini G. Infraspinatus strength assessment before and after scapular muscles rehabilitation in professional volleyball players with scapular dyskinesis. J Shoulder Elbow Surg 2010;19(8):1256-64.  https://doi.org/10.1016/j.jse.2010.01.022
  22. Tate AR, McClure PW, Kareha S, Irwin D. Effect of the Scapula Reposition Test on shoulder impingement symptoms and elevation strength in overhead athletes. J Orthop Sports Phys Ther 2008;38(1):4-11.  https://doi.org/10.2519/jospt.2008.2616
  23. Kibler WB, McMullen J. Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg 2003;11(2):142-51.  https://doi.org/10.5435/00124635-200303000-00008
  24. Warner JJ, Micheli LJ, Arslanian LE, Kennedy J, Kennedy R. Scapulothoracic motion in normal shoulders and shoulders with glenohumeral instability and impingement syndrome. A study using Moire topographic analysis. Clin Orthop Relat Res 1992;(285):191-9. 
  25. Donatelli R, Ellenbecker TS, Ekedahl SR, Wilkes JS, Kocher K, Adam J. Assessment of shoulder strength in professional baseball pitchers. J Orthop Sports Phys Ther 2000;30(9):544-51.  https://doi.org/10.2519/jospt.2000.30.9.544
  26. Ellenbecker TS, Mattalino AJ. Concentric isokinetic shoulder internal and external rotation strength in professional baseball pitchers. J Orthop Sports Phys Ther 1997;25(5):323-8.  https://doi.org/10.2519/jospt.1997.25.5.323
  27. Yamaura K, Mifune Y, Inui A, Nishimoto H, Kurosawa T, Mukohara S, et al. Relationship between glenohumeral internal rotation deficit and shoulder conditions in professional baseball pitchers. J Shoulder Elbow Surg 2021;30(9):2073-81.  https://doi.org/10.1016/j.jse.2020.10.041
  28. Newsham KR, Keith CS, Saunders JE, Goffinett AS. Isokinetic profile of baseball pitchers' internal/external rotation 180, 300, 450°.s-1. Med Sci Sports Exerc 1998;30(10):1489-95.  https://doi.org/10.1097/00005768-199810000-00004
  29. Hinton RY. Isokinetic evaluation of shoulder rotational strength in high school baseball pitchers. Am J Sports Med 1988;16(3):274-9.  https://doi.org/10.1177/036354658801600314
  30. Guney H, Harput G, Colakoglu F, Baltaci G. The effect of glenohumeral internal-rotation deficit on functional rotator-strength ratio in adolescent overhead athletes. J Sport Rehabil 2016;25(1):52-7.  https://doi.org/10.1123/jsr.2014-0260
  31. Lippitt SB, Vanderhooft JE, Harris SL, Sidles JA, Harryman DT 2nd, Matsen FA 3rd. Glenohumeral stability from concavity-compression: a quantitative analysis. J Shoulder Elbow Surg 1993;2(1):27-35.  https://doi.org/10.1016/S1058-2746(09)80134-1
  32. Andrade Mdos S, Fleury AM, de Lira CA, Dubas JP, da Silva AC. Profile of isokinetic eccentric-to-concentric strength ratios of shoulder rotator muscles in elite female team handball players. J Sports Sci 2010;28(7):743-9.  https://doi.org/10.1080/02640411003645687
  33. Noffal GJ. Isokinetic eccentric-to-concentric strength ratios of the shoulder rotator muscles in throwers and nonthrowers. Am J Sports Med 2003;31(4):537-41.  https://doi.org/10.1177/03635465030310041001
  34. Saccol MF, Gracitelli GC, da Silva RT, Laurino CF, Fleury AM, Andrade MS, et al. Shoulder functional ratio in elite junior tennis players. Phys Ther Sport 2010;11(1):8-11.  https://doi.org/10.1016/j.ptsp.2009.11.002
  35. Thomas SJ, Swanik KA, Swanik C, Huxel KC. Glenohumeral rotation and scapular position adaptations after a single high school female sports season. J Athl Train 2009;44(3):230-7.  https://doi.org/10.4085/1062-6050-44.3.230
  36. Zanca GG, Oliveira AB, Saccol MF, Ejnisman B, Mattiello-Rosa SM. Functional torque ratios and torque curve analysis of shoulder rotations in overhead athletes with and without impingement symptoms. J Sports Sci 2011;29(15):1603-11.  https://doi.org/10.1080/02640414.2011.608702
  37. Leroux JL, Codine P, Thomas E, Pocholle M, Mailhe D, Blotman F. Isokinetic evaluation of rotational strength in normal shoulders and shoulders with impingement syndrome. Clin Orthop Relat Res 1994;(304):108-15. 
  38. Warner JJ, Micheli LJ, Arslanian LE, Kennedy J, Kennedy R. Patterns of flexibility, laxity, and strength in normal shoulders and shoulders with instability and impingement. Am J Sports Med 1990;18(4):366-75.  https://doi.org/10.1177/036354659001800406
  39. Huang TS, Huang HY, Wang TG, Tsai YS, Lin JJ. Comprehensive classification test of scapular dyskinesis: a reliability study. Man Ther 2015;20(3):427-32.  https://doi.org/10.1016/j.math.2014.10.017
  40. McClure P, Tate AR, Kareha S, Irwin D, Zlupko E. A clinical method for identifying scapular dyskinesis, part 1: reliability. J Athl Train 2009;44(2):160-4.  https://doi.org/10.4085/1062-6050-44.2.160
  41. Kibler WB, Uhl TL, Maddux JW, Brooks PV, Zeller B, McMullen J. Qualitative clinical evaluation of scapular dysfunction: a reliability study. J Shoulder Elbow Surg 2002;11(6):550-6.  https://doi.org/10.1067/mse.2002.126766
  42. Ng GY, Lam PC. A study of antagonist/agonist isokinetic work ratios of shoulder rotators in men who play badminton. J Orthop Sports Phys Ther 2002;32(8):399-404.  https://doi.org/10.2519/jospt.2002.32.8.399
  43. Yu I, Kang M, Oh J. The effects of posterior shoulder stretch on rotator cuff strength ratio in adolescent baseball players with scapular dyskinesis: a randomized controlled trial. Isokinet Exerc Sci 2018;26(1):63-71.  https://doi.org/10.3233/IES-172176
  44. Forthomme B, Dvir Z, Crielaard JM, Croisier JL. Isokinetic assessment of the shoulder rotators: a study of optimal test position. Clin Physiol Funct Imaging 2011;31(3):227-32.  https://doi.org/10.1111/j.1475-097X.2010.01005.x
  45. Hill AM, Pramanik S, McGregor AH. Isokinetic dynamometry in assessment of external and internal axial rotation strength of the shoulder: comparison of two positions. Isokinet Exerc Sci 2005;13(3):187-95.  https://doi.org/10.3233/IES-2005-0203
  46. Cools AM, Witvrouw EE, Declercq GA, Danneels LA, Cambier DC. Scapular muscle recruitment patterns: trapezius muscle latency with and without impingement symptoms. Am J Sports Med 2003;31(4):542-9.  https://doi.org/10.1177/03635465030310041101
  47. Cools AM, Johansson FR, Cambier DC, Velde AV, Palmans T, Witvrouw EE. Descriptive profile of scapulothoracic position, strength and flexibility variables in adolescent elite tennis players. Br J Sports Med 2010;44(9):678-84.  https://doi.org/10.1136/bjsm.2009.070128
  48. Hannah DC, Scibek JS, Carcia CR. Strength profiles in healthy individuals with and without scapular dyskinesis. Int J Sports Phys Ther 2017;12(3):305-13. 
  49. Wang HK, Cochrane T. Mobility impairment, muscle imbalance, muscle weakness, scapular asymmetry and shoulder injury in elite volleyball athletes. J Sports Med Phys Fitness 2001;41(3):403-10. 
  50. Ellenbecker TS, Davies GJ. The application of isokinetics in testing and rehabilitation of the shoulder complex. J Athl Train 2000;35(3):338-50.