• 대한관절경학회:학술대회논문집
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• 대한관절경학회 2006년도 제15차 추계학술대회 심포지움
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• pp.35-39
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• 2006

Posterior capsular tightness with glenohumeral internal rotation deficit is usually considered to be an acquired condition of the throwing shoulder and is usually treated conservatively. However, because posterior capsular tightness is sometimes irreversible, we have performed arthroscopic capsular release for painful throwing shoulder with posterior capsular tightness. The true loss of internal rotation and posterior stiffness was confirmed by examination with the patient under anesthesia, and contracture of the posterior capsule and the posterior band of the inferior glenohumeral ligamant was observed arthroscopically. Because an extensive adhesion between the capsule and the fascia of the external rotators was noted, a capsular release was performed from 6 o'clock to 11 o'clock (in the right shoulder) to completely expose the muscle belly of the external rotators. Of the first 16 consecutive patients, 4 had no concomitant lesions and underwent posterior capsular release alone. With a minimum of 2 years' follow-up, it was ascertained that the throwing pain completely disappeared in 14 patients and improved in 2. In all, 11 patients returned to their preinjury performance level, and 5 returned to a lower level of function. In the 4 patients who had no concomitant lesions, throwing pain completely disappeared, and all were able to return to their preinjury performance level.

• Clinics in Shoulder and Elbow
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• 제6권2호
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• pp.138-142
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• 2003

The Bennett lesion is an extraarticular ossification of the posteroinferior quadrant of the glenoid. The lesion may be a source of shoulder pain in throwing athletes. The Bennett lesion may be caused by traction on the posterior band of the inferior glenohumeral ligamentous complex produced by posteroior subluxation during cocking, posterior subluxation during cocking, posterior decelerate forces during follow-through, or a combination of the two. Treatment is usually conservative and focused at the associated intraarticular abnormality and pathomechanics.

• Journal of Acupuncture Research
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• 제28권4호
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• pp.9-18
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• 2011

Objectives : This study was performed to evaluate the effects of the acupuncture therapy in combination with Soyeom pharmacopuncture therapy on acute whiplash injury by traffic accident. And thermal change of posterior neck and shoulder was observed. Methods : The clinical study was conducted to 20 cases of acute whiplash injury patients who had been admitted in Dept. of Acupuncture and Moxibusion, Woosuk University Hospital from December 1, 2010 to May 31, 2011. The patients were randomly divided into two groups. In one group(test group), patients were treated with the acupuncture therapy in combination with Soyeom pharmacopuncture therapy. And in the other group(control group), patients were treated with acupuncture therapy only. To estimate the efficacy of treatments, visual analog scale(VAS), neck disability index(NDI) of posterior neck pain were checked. And also thermal change of posterior neck and shoulder was observed by digital infrared thermographic imaging(DITI). Results : Both group represented effective improvement in VAS and NDI of posterior neck pain. Especially, test group is more effective than control group in VAS comparison, statistically. In test group, temperature of posterior neck and shoulder was decreased after treatments. But there was no significant difference between two groups on thermographic change. Conclusions : Through this study, Soyeom pharmacopuncture therapy is considered to be effective for reducing pain in acute whiplash injury patients. And after Soyeom pharmacopuncture therapy, temperature of posterior neck and shoulder show a tendency to decrease.

• Clinics in Shoulder and Elbow
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• 제6권1호
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• pp.55-66
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• 2003

Background: The purpose of this study was to evaluated results of arthroscopic treatment of the traumatic recurrent unidirectional posterior subluxation. Materials and Methods: We treated twenty-seven patients who had traumatic recurrent unidirectional posterior subluxation of the shoulder by arthroscopic labral repair and posterior capsular shift and prospectively evaluated for a mean of thirty-nine months (range,24 to 85 months). Patients who had posteroinferior instability, multidirectional instability, atraumatic onset, or revision cases were excluded. There were twenty-five male and two female patients with the mean age of twenty-one years (range, 14 to 33 years). All patients were involved in sports activity. All had a significant traumatic event prior to the onset of the instability. Stability, motion, three objective measurement (UCLA, ASES, and Rowe scores) and two subjective measurements (pain and function visual analogue scale) were evaluated. Results: The most common finding in magnetic resonance image-arthrogram was separation of the posteroinferior labrum without displacement in 9 patients, In arthroscopic examination, all patients had one or more lesions in the posterior inferior labrum and capsule. The most common finding was incomplete stripping of the posterior inferior labrum (18 patients). The posteroinferior capsule subjectively appeared to be stretched in twenty-two patients. At follow-up, all patients had improved shoulder function and scores(p < 0.01). All patients had stable shoulder by subjectivel and objectivel measurements, except one patient who had recurrent subluxation. All but one patient with postoperative recurrence were able to return to their prior sports activity with little or no limitation. Twenty-four patients were graded as having more than 90％ of shoulder function. Their were twenty-one excellent, five good, and one fair UCLA. scores. Pain sore improved from 4.5 to 0.2 point(p : 0.0001). Mean loss internal rotation was one vertebral level. None had operative complications. Conclusion: In conclusion, treatment outcomes of the traumatic unidirectional recurrent posterior subluxation are consistently reliable with respect to the stability, pain relief, and functional restoration by the arthroscopic posterior capsular shift procedure.

• 한국전문물리치료학회지
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• 제24권3호
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• pp.30-39
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• 2017

Background: Scapular posterior tilt (SPT) is important in the prevention of abnormal scapular movement and pain during elevation of the arm. However, previous studies have overlooked increased upper trapezius (UT) muscle activity interrupting the normal force couple of scapular motion and compensation of levator scapulae (LS) muscle activated simultaneously with UT during SPT exercise. Objects: The purpose of this study was to compare the effects of modified SPT with depression exercise versus SPT exercise on serratus anterior (SA), lower trapezius (LT), UT, and LS muscle activities and the clavicular tilt angle, in subjects with rounded shoulder posture (RSP) and myofascial pain in the UT muscle region. Methods: Eighteen subjects with RSP were recruited and randomly allocated to 2 groups; 9 in the SPT group and 9 in the SPT with depression group. All subjects met the specific RSP criteria and had myofascial pain of UT region. Depending on the allocated group, subjects performed the assigned SPT exercise and EMG data were recorded during the each exercise. Clavicular tilt angle was defined as the angle between the line joining the medial and lateral end of the clavicle and a horizontal line. Results: The SA muscle activity was significantly greater in SPT with depression than with SPT exercise (p<.05). The UT, LS muscle activity and the clavicular tilt angle was significantly lower in SPT with depression than with SPT exercise (p<.05). Conclusion: These findings were insightful because the potential risk of pain from overactivation of the UT and LS was considered, in contrast with SPT exercise. SPT with depression exercise can be implemented as an effective method to facilitate scapular muscle activity for stability and to prevent myofascial pain in the neck and shoulder.

• Clinics in Shoulder and Elbow
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• 제25권4호
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• pp.288-295
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• 2022

Background: There is no standardized therapeutic strategy for locked posterior shoulder fracture-dislocation (PSFD), and no consensus exists on the analysis of preoperative factors. This retrospective study aimed to evaluate functional results and complications in a series of PSFD cases managed with open surgical treatment. Methods: Patients diagnosed with locked PSFD who underwent open surgical treatment with reduction and osteosynthesis between April 2016 and March 2020 were included. All participants were treated with open reduction and internal fixation. Functional assessment used the modified University of California, Los Angeles (UCLA) mod scale, American Shoulder and Elbow Surgeons (ASES) questionnaire, subjective shoulder value (SSV), and visual analog scale (VAS). Complications were evaluated clinically and radiologically by X-ray and computed tomography. Results: Twelve shoulders were included (11 patients; mean age, 40.6 years; range, 19- 62 years). The mean follow-up duration was 23.3 months (range, 12-63 months). The UCLA mod, ASES, SSV, and VAS scores were 29.1±3.7, 81.6±13.5, 78±14.8, and 1.2±1.4 points, respectively. The overall complication rate was 16.6%, with one case of post-traumatic stiffness, 1 case of chronic pain, and no cases of avascular necrosis. Conclusions: Open surgical treatment of locked PSFD can achieve good functional results. A correct understanding of these injuries and good preoperative planning helped us to achieve a low rate of complications.

• 대한통합의학회지
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• 제12권1호
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• pp.139-150
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• 2024

Purpose : Scapular dyskinesis, it have been shown to be common in overhead athletes and has been associated with RC muscle strength. Posterior shoulder tightness (PST) has been suggested as an important factor causing scapular dyskinesis. Therefore, rehabilitation programs should focus on a posterior shoulder stretch combined with scapular stabilization exercise (PSSE) intervention. Determine the effects of posterior shoulder stretch combined with scapular stabilization exercise on the rotator cuff (RC) muscles strength, functional strength ratio (FSR), range of motion (ROM), and pain. Methods : 30 adolescent baseball players participated and subjects were allocated PSSE group (n=15) or the SSE group (n=15). Both group performed a 6-weeks intervention and measured of isokinetic peak torque/body weight (PT/BW) of concentric external rotator (CER), eccentric external rotator (EER), concentric internal rotator (CIR), eccentric internal rotator (EIR), FSR, ROM, and pain. Results : After 6 weeks PSSE, significant increase CER PT/BW (+6.02±4.76 %), EER PT/BW (+5.39±4.22 %), EER to CIR ratio (+.17±.16), and internal rotation ROM (+15.08±3.57 °). Whereas, significant decrease EIR to CER ratio (-.14±.18), external rotation ROM (-12.00±6.94 °), and GIRD (-17.41±2.84 °) compared with pre-intervention. No significant difference of isokinetic PT/BW of CIR and EER post-intervention. In the SSE group showed no significant difference all measurements for isokinetic PT/BW, FSR, and ROM post-intervention. The pain was significant improve both PSSE group (-3.25±1.60) and SSE group (-2.83±1.85) post-intervention. Conclusion : Both the PSSE and SSE interventions led to more pain relief. However, only the PSSE group showed ROM, CER, EER PT/BW, and FSR improvements. These results might suggest that the PSSE intervention is a more effective program for improving RC muscle strength and balance, in particular, concentric and eccentric ER muscle strength, FSR and can expect to prevent shoulder injuries in adolescent baseball players with scapular dyskinesis.

• 한국융합학회논문지
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• 제11권6호
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• pp.393-400
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• 2020

본 연구는 테니스 1st 플랫서브 동작에서 어깨 통증 유무에 따른 견갑골의 움직임 차이를 확인하기 위해 테니스 선수 15명(남8, 여7)을 대상으로 3차원 영상분석시스템을 활용하여 견갑골의 앞쪽/뒤쪽 기울임, 아래쪽/위쪽 회전 및 안쪽/바깥쪽 회전에 대한 각속도와 모멘트를 산출하여 이를 집단 간 비교 분석을 하였다. 그 결과, 앞쪽/뒤쪽 기울임에 대한 최대 각속도는 실험군인 어깨통증집단(SPG)보다 대조군 집단(CG)이 빠른 경향을 보였으며, 팔로우 스로우 구간을 제외하고 모든 국면에서 안쪽/바깥쪽 회전 최대 각속도가 SPG가 CG보다 빠른 것으로 나타났다. 후기 코킹 구간에서의 앞쪽/뒤쪽 기울임 최대 모멘트가 SPG보다 CG가 더 크게 나타났고 통계적으로 유의한 차이를 보였다. 코킹 구간의 위쪽/아래쪽 회전 최대 모멘트 또한 SPG가 CG보다 작게 나타나면서 통계적으로 유의한 차이를 보였다. 안쪽/바깥쪽 회전 모멘트는 모든 국면에서 CG가 SPG보다 큰 것으로 나타났다.

• 대한정형외과 초음파학회지
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• 제8권1호
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• pp.1-5
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• 2015

목적: 본 연구는 수평 내전 검사로 인해 견관절 후방부 동통의 악화를 보이는 환자에 대해서 초음파 유도 하에 스테로이드를 이용한 극하근 주사 치료 후 그 유용성에 대하여 평가하고자 하였다. 대상 및 방법: 2013년 5월부터 2014년 5월까지 견관절 후방부 통증을 주소로 내원한 환자 중 수평 내전 검사 시 동통의 악화를 보이는 21명을 대상으로 하였다. 외래에서 초음파 유도하에 극하근에 스테로이드 주사 치료를 시행하였으며 시술 전, 시술 후 3개월, 6개월로 나누어 VAS 통증 점수, UCLA 점수를 평가하였다. 결과: 스테로이드를 이용한 극하근 주사 치료 3개월 경과 시 환자들의 VAS 점수, UCLA 점수에서 임상적으로 유의하게 향상되었다(p<0.05). 시술 후 3개월과 6개월을 비교하면 VAS 점수와 UCLA 점수는 유의한 차이는 없었다(p>0.05). 6개월 추시 후 증상의 호전이 있는 완쾌 및 호전은 14예(67%)이었고, 호전이 없는 비호전 및 악화는 7예(33%)이었다. 결론: 초음파 유도 하에 스테로이드를 이용한 극하근 주사요법은 견관절 후방 통증이 있으며 수평 내전 시 통증이 악화되는 증상이 있는 환자들에게 유용한 시술이라고 생각된다.

• 대한물리치료과학회지
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• 제8권1호
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• pp.859-867
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• 2001

The purpose of this single subject care study was to evaluate the effectiveness of a functional electrical stimulation(FES) treatment program designed to prevent glenohumeral pint stretching and subsequent subluxation and shoulder pain in hemiplegic patients. The subject was a 43-year-old male who had left side hemiparesis with shoulder pain and subluxation on affected side. He received conventional physical therapy and additional FES therapy where two flaccid shoulder muscles, supraspinatus and posterior deltoid. were induced to contract repetitively up to 20 minutes for 2 weeks. As a result. the patient showed improvements in hemiplegic arm function, reduction in subluxation(as indicated by Jig test) and range of motion(SLROM). But it was difficult to generalize. We concluded that the FES program was effective in reducing the severity of shoulder subluxation and pain. Further study must be evaluated its statistical significance.