Effect of Posterior Capsule Tightness on Glenohumeral Translation in the Late-Cocking Phase of Pitching

in Journal of Sport Rehabilitation
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Context:

Throwing injuries.

Objective:

To study the effects of posterior capsule tightness on humeral head position in late cocking simulation.

Design:

Eight fresh frozen shoulders were placed in position of “late cocking,” 90 degrees abduction, and 10 degrees adduction and maximal external rotation. 3D measurements of humeral head relationship to the glenoid were taken with an infrared motion sensor, both before and after suture plication of the posterior capsule. Plications of 20% posterior/inferior capsule and 20% entire posterior capsule were performed, followed by plications of 40% of the posterior/inferior capsule and 40% entire posterior capsule.

Setting:

Cadaver Lab.

Intervention:

Posterior capsular placation.

Main Outcome Measures:

Humeral head position.

Results:

40%, but not 20%, posterior/inferior and posterior plications demonstrated a trend to increased posterior-superior humeral head translation relative to controls.

Conclusion:

Surgically created posterior capsular tightness of the glenohumeral joint demonstrated a nonsignificant trend to increased posterior/superior humeral head translation in the late cocking position of throwing.

Kim M. Clabbers, MD, is with Bucks Orthopedic Surgery Associates in Levittown, PA. John D. Kelly, IV, MD; Dov Bader; Matthew Eager; and Ray A. Moyer, MD are with the Department of Orthopedic Surgery at Temple University in Philadelphia, PA. E-mail johndkellyiv@aol.com. Carl Imhauser, MS and Sorin Siegler, PhD are with the Department of Mechanical Engineering and Mechanics at Drexel University in Philadelphia.