Introduction In regards to mobility, the glenohumeral (GH) joint is one of the best the human body has to offer. It allows for the range of motion needed for the activities of daily living that we have all grown accustomed to. In order to execute these motions, however, the shoulder joint needs a stable base of support. This is one of the primary roles of the scapula and its surrounding musculature. When the GH joint is injured, however, scapular muscle-activation, and therefore stability and function, is theoretically altered. Many shoulder rehabilitation programs focus on restoring proper coordination of these muscles, especially those involved with scapular upward-rotation. Until recently, however, there has not been much research supporting the relationship between muscle-activation ratios and shoulder injuries, nor the ability to preferentially activate scapular muscles using rehabilitation exercises. Furthermore, the purpose of this study was to determine if there are differences in muscle-activation ratios between healthy individuals and those with GH injuries, as well as evaluate muscle-activation during particular rehabilitation exercises (Moeller, Huxel Bliven, & Snyder Valier, 2014).
Methods
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They defined one independent variable as group, referring to either healthy control or GH injury. The other independent variable was defined as functional exercise, which consisted of bow and arrow (BA), external rotation with scapular squeeze (ERSS), lawnmower, and robbery. The dependent variables were identified as normalized muscle-activation from the serratus anterior (SA), upper trapezius (UT), middle trapezius (MT), and lower trapezius (LT). These values were used to calculate ratios of muscle-activation (Moeller, Huxel Bliven, & Snyder Valier,
In response to this article, I think I chose this mostly due to the Pathos argument made by Adam Plantinga. His story is very compelling and pursuasive given his background on the issue. Also Platinga had some truly captivating insights into the field of gun violence, and how gun control can effect it. He stated that yes, many gun control advocates like Pheobe Maltz who think that simply banning guns will get rid of the problem. When the truth is, if someone wants to aquire a gun enough. They will always be able to get one. But he counters that we should still try to make it as inconvenient for mass shooters to get their hands on those weapons as possible. And I found that to be a very relatable and reasonable statement. It really does make
The participants included 87 individuals (28 men, 49 women) with various shoulder dysfunctions who were assessed during a routine clinical evaluation and consented for shoulder arthroscopy. Also, all individuals were required to have a magnetic resonance image (MRI), to have completed the dedicated special tests of interest in the study, and to have a detailed diagnosis after arthroscopic surgery.
In 1930, President Theodore Roosevelt instituted the United States Department of Veterans Affairs (VA) for the purpose of providing for those who served in the military and their dependants. Because the VA is dedicated to providing care to those who have made a sacrifice for our country, it is often held to a higher standard than other healthcare providers, however, many have criticized the VA for failing the veterans by being financially wasteful, ethically unsound, and inefficient in providing health care. As of late, the VA has been seen in a negative light due to an influx of scandals, and many have began questioning who should responsible for fixing the issues that haunt the VA. The VA cannot be allowed to continuously fail these
The purpose of this study was to discuss the disable throwing shoulder with a focus on the SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation. SICK stands for Scapular malposition, Inferior medial border prominence, coracoid pain and palposition, and dykinesis of scapular movement. Appearing on examination as if one shoulder is lower than the other, SICK is asymmetric malposition of the scapula in the dominant throwing shoulder. They are grouped into 3 clinically recognizable patterns of scapular dyskinesis. Type I which is inferior medial scapular border prominence and type II, medial scapular border prominence. While those are 2 most commonly associated with labral pathology, type III is towards impingement and rotator
For shoulder flexion 61% of the variance could be accounted for by the sit-and-reach. A correlation was also found between the modified sit-and-reach test and both the shoulder extension and hip flexion tests. For shoulder extension 33% of the variance was accounted for by the modified sit-and-reach and for hip flexion 22% of the variance was accounted for by the modified sit-and-reach.
Glenohumeral joint kinematics change in an adaptive manner to chronic overhead activity, seen in multiple sports especially in baseball, volleyball, handball, and basketball(16-18). This involves all tissues of the shoulder – bone, capsule, and muscle(19). During normal human development the humeral head rotates from a retroverted position at birth to an anteverted position as an adult. However, when individuals begin overhead throwing at an early age, extrinsic forces on the humerus cause the humeral head to remain in relative retroversion compared to that of the non-dominant arm. This, combined with tightness of the posteroinferior capsule from chronic reactive scarring, and with scapular
This followed fastballs throws at 18.4 m from a mound at 3 different effort levels: 60%, 80%, and full effort. Kinetic values for humeral internal rotational torque and elbow valgus load were recorded for each throw. Repeated-measures analyses of variance were used to compare all 7 throwing conditions within pitchers. Kinetic data was also compared against ball velocity to determine throwing efficiency. A separate analysis was also conducted using a 3-level repeated-measures analysis of variances comparing just the variable-effort throws from the mound. There were significant differences in humeral IR and elbow valgus load off the mound at 60-100%. The study showed that partial effort pitching placed lower loads on the shoulder and elbow. Flat ground throwing had similar loads with pitching from the mound but at a significantly lower ball velocity. The mechanical advantage of throwing from a mound or using the crow hop is likely protective during rehabilitation and training throws. Repetitive use of the shoulder and elbow in overhead athletes places stress and physiological limits leading to breakdown, furthermore
*insert article *attachedBesides being able to see the inside of a shoulder, doctors use different physical tests to evaluate the shoulder in order to determine what type of injury and how severe an injury may be. One such test was recently developed by Dr. Carl J. Basamania at the Womack Army Medical center in Fort Bragg, N.C. The test was developed to evaluate shoulder instability in a patient. During the test the Dr. or examiner stands next to the patient who is to lay flat on his/her back. The hand of the examined should is held firmly by the examiner. The examiner then pushes against the clavicle to stabilize th scapula, while they also gently hold the pectoral muscle with their thumb in order to be able to assess relaxation. The examiner then rotates the arm form neutral to full external rotation. If the patient has AIGHL incompetence there is a lack of tightening as the arm reaches full external rotation. The test has appeared to be highly accurate and may be of value to Dr.'s and surgeons alike. After doctors have determined what type and what degree of injury a patient has sustained using various tests it is on to the next step, rehabilitation.
To provide measurements for safe reintroductions of the athletes to their respected sports, Standard Functional Tests (SFT) have been developed. (8,9,10) Most of these tests combined complex movements together to test and measure strength and neuromuscular control of athletes with activities that resemble athletic movements such as jumping, landing, and cutting. No universal accepted protocol exists to date (11), however, hop tests are the most common used in determining return to play follow ACL reconstruction (12) and have shown good reliability (13,14) and validity (14). Hop tests include single leg hop (SLH), triple hop (TH), cross over hop (COH), and timed hops (15). The single leg hop has been studied extensively and can help detect function limitations for up to 54 weeks postoperatively with good test-retest reliability. (16,17,18,19,20) It has also been shown to be
The differing results are likely because of differences in skill level among test subjects, methods of evaluation, and erratic sprint distances. The main strength qualities being explored in this data analysis are: absolute strength, relative strength, high-load speed strength, and low-load speed strength. Every sport requires several combinations of these strength qualities to be successful (13). Absolute strength is the measurement of how much force a subject can exert with no regard to body size (3). Relative strength is the measurement of strength to body size. High-load speed strength is the ability for the muscle to exert a high amount of force while contracting at a high speed. The tests to gauge high-load speed strength are typically short in nature, executed at maximal speeds, and produce high power outputs, and include exercises such as the power clean, snatch, and push jerk (1). Triple extension of the hips, knees, and ankles during these movements allows the athletes to express force against the ground rapidly. Low-load speed strength involves low velocity movements, and is a quality that “reflects the dynamic abilities necessary for sport. They are the maximal strength tests of choice for strength and conditioning professionals”
Conditioning is always specific to the injury and the athlete involved. Rehabilitation procedures following a dislocated shoulder will differ, as it will include strengthening the rotator cuff muscles as soon as it is possible. These are the muscles that are used to stabilise the shoulder joint and are often damaged and weakened after a dislocation. Often, these exercises don’t involve any light weights but more isometric exercises to strengthen the muscles. These strengthening exercises should begin with isometric contractions such as extension, adduction and rotations. Rotations are particularly effective as they target the rotator cuff muscles that are used to strengthen the stability of the shoulder joint. Like the hamstring, these movements
The consequences of weak muscles around the scapula affect your arm movements and strength as well as your posture. The scapula is important for a variety of movements of the arm by moving the glenoid fossa into the best position for the head of the humerus. Elevating the scapula uses your levator scapulae, rhomboids, and trapezius 1 and 2 muscles. Elevation of the scapula allows you to shrug and lift your shoulders up. If the muscles needed for elevating your scapula are weak, then your shoulders wouldn’t be able to lift if someone pushes down on them. Trapezius 1 and 2 are used when are carrying something heavy with your hand by your side and with them being weak you wouldn’t be able to carry heavy things for long distances or maybe not at
608) puts forth in their report that the glenohumeral joint is the most movable joint in the body that is at the risk of decreased stability, therefore, complex interaction between static (osseous, soft tissue stabilizers) and dynamic stabilizers (tendon-muscle complex) commands elaborate balance and synchronicity. Any disruption in this intricate mechanism can lead to shoulder instability. In the research study of Rerko, Pan, Donaldson, Jones, & Bishop (2013), the examiners systematically interrupted the glenoid bone to show if it has any effect on the stability of the shoulder and if there is any impact, what imaging modality would be the best to demonstrate it to guide the surgeon in repairing the shoulder instability. The researchers used fresh cadavers shoulders and strategically created defects to the glenoid bone. Imaging modalities such as X-rays, CT scan, and MRI were taken. Measurement of the specificity and sensitivity of the various diagnostic imaging were made, and 3D CT scan has demonstrated a very high specificity and sensitivity compared to the other imaging tools. Furthermore, Bishop, Jones, Rerko, & Donaldson (2013, p. 1255) asserted the significance of preoperative 3-D CT scan to determine the anterior shoulder instability with a concern for a osseous loss of the glenoid bone. The authors believe that 3D CT scan is the most consistent imaging modality in providing an estimation of the bone deterioration compared
Increasing the stability and decreasing spasticity while strengthening muscles surrounding the joint over a six-week period will improve scapular stabilization thus improving scapulohumeral rhythm, which is an essential part of healthy shoulder function. The results of this study used a combination of stretching and joint stabilization exercises for spastic joint dysfunction in the selected patients reversed the pathological changes in tendons and improved shoulder function. This is seen by the results discussed with the affected tendons being measured before and after the study showing a decrease in the thickness of the tendons over time. The third group had the greatest decrease in thickness. This group was the one that received 15 minutes of joint stabilization exercise and 15 minutes of stretching. The other two groups showed a decrease as well, however, less difference than the third. One of the groups had 30 minutes of joint stabilization exercise while the other had 30 minutes of stretching (Young Youl You, Jin Gang Her, Ji-Hea Woo, Taesung Ko, & Sin Ho Chung,
Proprioceptive rehabilitation methods look to return the ankle to its previous risk factor level, and return it to its previous function level. Scott et. al (1997) says that afferent feedback to the brain and spinal pathways is mediated by skin, articular, and muscle mechanoreceptors. Rehabilitation aims to re-establish those spinal pathways so that movements can be performed fully again. Scott et. al (1997) believes that rehabilitation programs should be designed to include a proprioceptive component that addresses the following three levels of motor control: spinal reflexes, cognitive programming, and brainstem activity. A program which is set out in this way is highly recommended to promote and return dynamic joint and functional stability. Another study, conducted by Lephart (1995), examined the role of proprioceptive training in the treatment of injuries, and also looked at recent developments in the area of proprioceptive rehabilitation methods. Lephart (1995) notes that ligaments play a major role in normal joint kinematics, providing mechanical restraint to abnormal joint movement when a stress is placed on the joint. Following injury to these tissues there is a loss of mechanical stability to the joint, resulting in changes to normal kinematics. Management of these sport-related injuries focuses on restoring joint kinematics by enhancing muscular stabilisation through rehabilitation. By restoring joint stability through rehabilitation, the athlete should be able to return to playing sport, while the chance of re-injury will be reduced. Some believe that rehabilitation of ankle injuries should be set and individualised for each athlete as no athlete or injury is the same, and react differently to different exercises. Carl (2002) said that in the acute phase, the focus should be on controlling the inflammation and once pain is gone and