• Journal of the Korean Society of Physical Medicine
• /
• v.11 no.4
• /
• pp.1-9
• /
• 2016

PURPOSE: The aim of this study was to examine the effects of abdominal breathing and thoracic expansion exercises on craniovertebral and cranial rotation angles in patients with rotator cuff injury. METHODS: This study enrolled 19 patients with rotator cuff injury, and ten and nine of the patients were randomly placed in abdominal breathing and thoracic expansion exercise groups, respectively. After pain treatment in each group, breathing exercise was conducted thrice a week for four weeks. The patients were recorded by using a digital camera and Image J (version 1.46, National Institutes of Health, USA), an angle measurement program, was used to analyze changes in the craniovertebral angle, cranial rotation angle, and sagittal shoulder posture. RESULTS: Statistically significant differences in the craniovertebral angle were found in both the abdominal breathing and thoracic expansion exercise groups (p<.05). A significant difference in cranial rotation angle was found in the thoracic expansion exercise group only (p<.05). No statistically significant differences in sagittal shoulder posture were found in both groups (p>.05). CONCLUSION: Although abdominal breathing and thoracic expansion exercises did not effectively change sagittal shoulder posture, the exercises were effective in improving craniovertebral and cranial rotation angles. Therefore, abdominal breathing and thoracic expansion exercises are suggested as effective exercise programs for forward head posture.

• Clinics in Shoulder and Elbow
• /
• v.1 no.2
• /
• pp.167-174
• /
• 1998

Since the first description by Cotton, there have been sporadic reports about the inferior subluxation of the shoulder. Nevertheless there is still a lack of consensus regarding the mechanism of occurrence, evolution and treatment. We have experienced six cases of inferior sublusation(five cases after trauma and one case after surgery) which resolved over time. Analysis of the clinical informations including serial radiographs, data from clinical examination and electromyography(EMG) revealed the following results. All the five post-traumatic inferior subluxations were noted in women with an average age of 59 years after direct trauma resulting in fracture of the proxiaml hrnerus(4) or clavicle(1), of which nerve injury was proven by EMG in three. One case occurred after Bankart repair by stretch injury to the axillary nerve. The presenting symptom was unusually severe pain on passive motion. Absence of anterior or posterior displacement wasl confirmed by radiographs. All the cases seemed to have delayed onset of subluxation except one. The subluxed hu.meral head was concentrically reduced at an average 11 weeks(range 3-23 weeks) from the supposed time of occurrence and the acromiohumeral interval measUred on the standing anteroposterior radiographs decreased to 9.4 mm ftom 23 mm. Improvement of pain paralled the reduction. In conclusion, the most common cause of transient inferior subluxation was nerve injury in ou~ series and the prognosis was excellent, however protraction of recovery or leaving permanent subluxation would be possible if .the injured nerve is unrecoverable.

• Clinics in Shoulder and Elbow
• /
• v.13 no.1
• /
• pp.92-98
• /
• 2010

Purpose: To analyze results of treating acromioclavicular injuries using clavicle hook plates. Materials and Methods: Between February 2008 and April 2010, 18 patients with acromioclavicular joint injury treated by clavicle hook plates were reviewed. Using the Rockwood classification, 7 dislocations were classified as type III injuries and 11 as type V injuries. Implant removal was done at least 3 months from initial fixation. Simple X-rays were taken for comparing the state of reduction, and clinical outcomes were evaluated by the Korean Shoulder Scoring System and the American Shoulder Elbow Society score. The average follow-up period was 9 months. Results: On weight bearing X-rays, the average coracoclavicular distance showed a 114% increase compared to the contralateral side at the time of injury. It decreased to 23% by the last follow-up. The mean Korean Shoulder Scoring System and the American Shoulder Elbow Society score were 80 and 74 at the last follow-up. Conclusion: The immediate stability these plates provide allows rapid rehabilitation. Clavicle hook plate fixation for acromioclavicular joint dislocation is considered an effective method for ensuring satisfactory results both radiologically and clinically.

• Clinics in Shoulder and Elbow
• /
• v.8 no.2
• /
• pp.131-134
• /
• 2005

Distal clavicle tunnel widening was observed in coracoclavicular ligament reconstruction with semitendinous tendon autografts in a patient with acromioclavicular joint injury. Acromioclavicular joint separation, in a 44 years-old man was treated by coracoclavicular ligament reconstruction. We have performed x-ray evaluation on 2years 10months after surgery. The immediate postoperative tunnel size was measured 4.5mm in diameter. At postoperative 2years 10month the tunnel diameter was from 9.3 to 11.4mm. But the weightbearing clavicle view showed no significant acromioclavicular joint separation. Moreover the patient complained only minor intermittent shoulder discomfort.

• Clinics in Shoulder and Elbow
• /
• v.25 no.4
• /
• pp.334-338
• /
• 2022

Currently, the literature contains few studies that describe any potential complications following arthroscopic acromioplasty. Because part of the anterior deltoid originates from the anterior acromion, there is a risk for violation and subsequent iatrogenic rupture or avulsion during this procedure. This type of injury can be a devastating problem for patients that may lead to poor function and debilitating pain. We present a patient with deltoid insufficiency following arthroscopic acromioplasty who elected to proceed with operative management with a planned arthroscopic evaluation of the shoulder followed by an open deltoid repair. At the final follow-up visit 2.5 years postoperatively, the patient reported improved pain from baseline and no residual disability and was able to perform most activities of daily living without difficulty. This case serves as an example of a surgical repair for a deltoid avulsion following arthroscopic acromioplasty. As there is still a lack of standard guidelines, our suture repair technique can be considered one method of treatment for this type of injury.

• Clinics in Shoulder and Elbow
• /
• v.26 no.3
• /
• pp.323-329
• /
• 2023

Rotator cuff tear is a common shoulder injury that compromises both function and quality of life. Despite the prevalence of the injury and advancements in repair techniques, a significant percentage of these repairs fail. This review aims to explore the multifactorial reasons behind this failure, including the degenerative nature of the rotator cuff tendon, inherent and extrinsic factors, and the role of hypoxia in tissue degeneration. Additionally, it elucidates potential strategies for improving healing outcomes.

• Korean Journal of Applied Biomechanics
• /
• v.25 no.3
• /
• pp.301-309
• /
• 2015

Objective : The purpose of this study was to describe the correlation between the activity of the muscles of upper and lower limbs of a golf driver swing according to shoulder injury. Method : The subjects were 18 professional golfers (7 male in KPGA and 11 female in KLPGA). Using surface electromyography, we evaluated muscle activities during the golf drive swing. Surface electrodes were used to record the level of muscle activity in the left Deltoid(MD), Triceps Brachii(TB), Pectoralis(PM), Trapezius(UT), Rectus Femoris(RF), Vastus Medialis Obilique(VMO), Biceps Femoris(BF), Gastrocnemius(GCM) muscles during the golfer's swing. The golf swing was divided into five phases: take away, forward swing, acceleration, early follow through, late follow through. Results : The results can be summarized as follows: MD, VMO had statistically significant difference in take away phases, GCM had statistically significant difference in acceleration phases, MD, PM, VMO had statistically significant difference in early follow through phases, PM had statistically significant difference in late follow through phases, Conclusion : Muscle activity of the 8 muscles(Deltoid, Triceps Brachii, Pectoralis, Trapezius, Rectus Femoris, Vastus Medialis Obilique, Biceps Femoris, Gastrocnemius) along the shoulder damage or absence of has shown that they are organically connected to each of the phases.

• Clinics in Shoulder and Elbow
• /
• v.25 no.3
• /
• pp.240-243
• /
• 2022

Isolated deltoid paralysis is a rare pathology that can occur after axillary nerve injury due to shoulder trauma or infection. This condition leads to loss of deltoid function that can cause glenohumeral instability and inferior subluxation, resulting in rotator cuff muscle fatigue and pain. To establish dynamic glenohumeral stability, a novel technique was invented. Humeral suspension is achieved using a double button implant with non-resorbable high strength cords between the acromion and humeral head. This novel technique was used in two patients with isolated deltoid paralysis due to axillary nerve injury. The results indicate that the humeral suspension technique is a method that supports centralizing the humeral head and simultaneously dynamically stabilizes the glenohumeral joint. This approach yielded high patient satisfaction and reduced pain. Glenohumeral alignment was improved and remained intact 5 years postoperative. The humeral suspension technique is a promising surgical method for subluxated glenohumeral joint instability due to isolated deltoid paralysis.

• Clinics in Shoulder and Elbow
• /
• v.19 no.1
• /
• pp.15-19
• /
• 2016

Background: To investigate how many rookie pitchers suffered from injuries while playing in the amateur league without guidelines for prevention of excessive pitching, we analyzed their amateur pitching patterns based on the pitch count, use of breaking balls, and pitches during winter camp. Methods: Forty-one rookie pitchers who graduated from high school or university in 2013 and joined professional baseball teams. Participants were interviewed by a trainer using our questionnaire. Injury inclusion criteria were 1) history of shoulder surgery, 2) history of elbow surgery, 3) shoulder pain requiring treatment, and 4) elbow pain requiring treatment. Results: Mean number of pitches per game and warm-up pitches for practice was 84.5 pitches (range, 15 to 130 pitches) and 16.4 pitches (range, 2 to 210 pitches), respectively. Mean number of pitches during the last year was 906.9 (range, 80 to 2,000). Mean number of maximal pitches was 127 pitches (range, 50 to 210 pitches). Fourteen pitchers had pitched over 150 pitches. Twenty-seven pitchers (65.9%) had pitched in spite of enduring pain. During winter training (mean 1.8 months), mean number of pitches per day was 162.5 pitches, and 20 pitchers (48.8%) had practiced pitching excessively despite the cold weather. Twenty-six rookies (63.4%) had shoulder pain or history of shoulder surgery, and 31 pitchers (75.6%) had elbow pain or history of elbow surgery. Only four participants (9.8%) did not have pain and history of surgery. Conclusions: For young baseball pitchers, guidelines for prevention of excessive pitching and for regulating the winter training program may be needed.

• Korean Journal of Applied Biomechanics
• /
• v.13 no.3
• /
• pp.151-162
• /
• 2003

The purpose of this study was to investigate the frequency of sports injury among Korean junior elite golf players. The survey was made through the questionnaire which consist of eight categories and 280 valid answers were used to perform frequency analysis. The results indicated that 197 out of 280 participants experienced golf injuries (30%: during a game, 70%: during a practice) and 70% of them also experienced injuries within a year. The frequency analysis for the site of injury has shown that back was the most vulnerable area for all players(33%), followed by the right wrist, left shoulder and elbow for male players. Among female players, left wrist was the second weak site of injury, followed by the right wrist, right thoracic spine, and left shoulder. A few of them also have shown abnormal symptoms of ruptured lumbar disk, scoliosis, and lordosis and these injuries might be caused by the lack of flexibility and the fatigue due to over-practice. High frequency of wrist injury also demonstrated that excessive chopping or punching shot and poor environmental course conditions may cause this injury to be common. Overall, lack of warm up time, lack of strength and flexibility, and excessive amount of practice were the major reasons of injury for the junior elite golfers in Korea. The study also proved that these young Korean golfers actually had more chances to be faced with the injury than average. Thus, it is necessary to develop systematic and scientific methods of training, and prevention, treatment of these injuries with medical professionals.