Sensorimotor Control of the Shoulder in Professional Volleyball Players With Isolated Infraspinatus Muscle Atrophy

in Journal of Sport Rehabilitation
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Context: Isolated infraspinatus muscle atrophy (IIMA) affects only the hitting shoulder of overhead-activity athletes and is caused by suprascapular nerve neuropathy. No study has assessed the static and dynamic stability of the shoulder in overhead professional athletes with IIMA to reveal possible shoulder sensorimotor alterations. Objective: To assess the shoulder static stability, dynamic stability, and strength in professional volleyball players with IIMA and in healthy control players. Design: Cross-sectional study. Setting: Research lab. Patients or Other Participants: A total of 24 male professional volleyball players (12 players with diagnosed IIMA and 12 healthy players) recruited from local volleyball teams. Intervention(s): Static stability was evaluated with 2 independent force platforms, and dynamic stability was assessed with the “Upper Quarter Y Balance Test.” Main Outcome Measure(s): The static stability assessment was conducted in different support (single hand and both hands) and vision (open and closed eyes) conditions. Data from each test were analyzed with analysis of variance and paired t-test models to highlight statistical differences within and between groups. Results: In addition to reduced abduction and external rotation strength, athletes with IIMA consistently demonstrated significant less static (P < .001) and dynamic stability (P < .001), compared with the contralateral shoulder and with healthy athletes. Closed eyes condition significantly enhanced the static stability deficit of the shoulder with IIMA (P = .04 and P = .03 for both hand and single hand support, respectively) but had no effect on healthy contralateral and healthy players’ shoulders. Conclusions: This study highlights an impairment of the sensorimotor control system of the shoulder with IIMA, which likely results from both proprioceptive and strength deficits. This condition could yield subtle alteration in the functional use of the shoulder and predispose it to acute or overuse injuries. The results of this study may help athletic trainers and physical/physiotherapists to prevent shoulder injuries and create to specific proprioceptive and neuromuscular training programs.

The authors are with the Department of Experimental Medicine, University of Perugia, Perugia, Italy.

Contemori (samuele.contemori@unipg.it) is corresponding author.
  • 1.

    Escamilla RF, Andrews JR. Shoulder muscle recruitment patterns and related biomechanics during upper extremity sports. Sport Med. 2009;39:569590. PubMed ID: 19530752 doi:10.2165/00007256-200939070-00004

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Reeser JC, Fleisig GS, Bolt B, Ruan M. Upper limb biomechanics during the volleyball serve and spike. Sports Health. 2010;2:368374. PubMed ID: 23015961 doi:10.1177/1941738110374624

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Wagner H, Pfusterschmied J, Tilp M, Landlinger J, von Duvillard SP, Müller E. Upper-body kinematics in team-handball throw, tennis serve, and volleyball spike. Scand J Med Sci Sports. 2014;24:345354. PubMed ID: 22813080 doi:10.1111/j.1600-0838.2012.01503.x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    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;41:403410. PubMed ID: 11533574

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Wilk KE, Obma P, Simpson CD, Cain EL, Dugas JR, Andrews JR. Shoulder injuries in the overhead athlete. J Orthop Sports Phys Ther. 2009;39:3854. PubMed ID: 19194026 doi:10.2519/jospt.2009.2929

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Connor PM, Banks DM, Tyson AB, Coumas JS, D’Allesandro DF. Magnetic resonance imaging of the asymptomatic shoulder of overhead athletes: a 5-year follow-up study. Am J Sports Med. 2003;31:724727. PubMed ID: 12975193 doi:10.1177/03635465030310051501

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Jost B, Zumstein M, Pfirrmann CW, Zanetti M, Gerber C. MRI findings in throwing shoulders: abnormalities in professional handball players. Clin Orthop Relat Res. 2005;434 :130137. PubMed ID: 15864042 doi:10.1097/01.blo.0000154009.43568.8d

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Lajtai G, Prrmann CWA, Aitzetmller G, Pirkl C, Gerber C, Jost B. The shoulders of professional beach volleyball players: high prevalence of infraspinatus muscle atrophy. Am J Sports Med. 2009;37:13751383. PubMed ID: 19359418 doi:10.1177/0363546509333850

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Young SW, Dakic J, Stroia K, Nquyen ML, Harris AH, Safran MR. High incidence of infraspinatus muscle atrophy in elite professional female tennis players. Am J Sports Med. 2015;43:19891993. PubMed ID: 26078449 doi:10.1177/0363546515588177

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Boykin RE, Friedman DJ, Higgins LD, Warner JJ. Suprascapular neuropathy. J Bone Joint Surg Am. 2010;92:23482364. PubMed ID: 20926731 doi:10.2106/JBJS.I.01743

  • 11.

    Dramis A, Pimpalnerkar A. Suprascapular neuropathy in volleyball players. Acta Orthop Belg. 2005;71:269272. PubMed ID: 16035699

  • 12.

    Ferretti A, De Carli A, Fontana M. Injury of the suprascapular nerve at the spinoglenoid notch: the natural history of infraspinatus atrophy in volleyball players. Am J Sports Med. 1998;26:759763. PubMed ID: 9850775 doi:10.1177/03635465980260060401

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Witvrouw E, Cools A, Lysens R, et al. Suprascapular neuropathy in volleyball players. Br J Sports Med. 2000;34:174180. PubMed ID: 10854016 doi:10.1136/bjsm.34.3.174

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Reeser JC, Fleisig GS, Cools AM, Yount D, Magnes SA. Biomechanical insights into the aetiology of infraspinatus syndrome. Br J Sports Med. 2013;47:239244. PubMed ID: 22535535 doi:10.1136/bjsports-2011-090918

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Myers JB, Lephart SM. The role of the sensorimotor system in the athletic shoulder. J Athl Train. 2000;35:351363. PubMed ID: 16558648

  • 16.

    Myers JB, Oyama S. Sensorimotor factors affecting outcome following shoulder injury. Clin Sports Med. 2008;27:481490. PubMed ID: 18503879 doi:10.1016/j.csm.2008.03.005

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Myers JB, Wassinger CA, Lephart SM. Sensorimotor contribution to shoulder stability: effect of injury and rehabilitation. Man Ther. 2006;11:197201. PubMed ID: 16777465 doi:10.1016/j.math.2006.04.002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Riemann BL, Lephart SM. The sensorimotor system, part I: the physiologic basis of functional joint stability. J Athl Train. 2002;37:7179. PubMed ID: 16558670

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Riemann BL, Lephart SM. The sensorimotor system, part II: the role of proprioception in motor control and functional joint stability. J Athl Train. 2002;37:8084. PubMed ID: 16558671

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Salles JI, Cossich VR, Amaral MV, et al. Electrophysiological correlates of the threshold to detection of passive motion: an investigation in professional volleyball athletes with and without atrophy of the infraspinatus muscle. Biomed Res Int. 2013;2013:19. PubMed ID: 23484136 doi:10.1155/2013/634891

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Edouard P, Gasq D, Calmels P, Ducrot S, Degache F. Shoulder sensorimotor control assessment by force platform: feasibility and reliability. Clin Physiol Funct Imaging. 2012;32:409413. PubMed ID: 22856350 doi:10.1111/j.1475-097X.2012.01140.x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Edouard P, Gasq D, Clamels P, Degache F. Sensorimotor control deficiency in recurrent anterior shoulder instability assessed with a stabilometric force platform. J Shoulder Elbow Surg. 2014;23:355360. PubMed ID: 24007652 doi:10.1016/j.jse.2013.06.005

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Butler RJ, Myers HS, Black D, et al. Bilateral differences in the upper quarter function of high school aged baseball and softball players. Int J Sports Phys Ther. 2014;9:518524. PubMed ID: 25133080

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Gorman PP, Butler RJ, Plisky PJ, Kiesel KB. Upper Quarter Y Balance Test: reliability and performance comparison between gender in active adults. J Strength Cond Res. 2012;26:30433048. PubMed ID: 22228174 doi:10.1519/JSC.0b013e3182472fdb

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Westrick RB, Miller JM, Carow SD, Gerber JP. Exploration of the Y-Balance test for assessment of upper quarter closed kinetic chain performance. Int J Sports Phys Ther. 2012;7:139147. PubMed ID: 22530188

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Myers H, Poletti M, Butler RJ. Functional performance on the Upper Quarter Y-Balance Test differs between high school wrestlers and baseball players. J Sports Rehabil. 2017;26(3):253259. PubMed ID: 27632876 doi:10.1123/jsr.2015-0168

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Gerber C, Blumenthal S, Curt A, Werner CM. Effect of selective experimental suprascapular nerve block on abduction and external rotation strength of the shoulder. J Shoulder Elbow Surg. 2007;16:815820. PubMed ID: 17931906 doi:10.1016/j.jse.2007.02.120

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Uhl TL, Carver TJ, Mattacola CG, Mair SD, Nitz AJ. Shoulder musculature activation during upper extremity weight-bearing exercise. J Orthop Sports Phys Ther. 2003;33:109117. PubMed ID: 12683686 doi:10.2519/jospt.2003.33.3.109

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Wilk KE, Arrigo C. Current concepts in the rehabilitation of the athletic shoulder. J Orthop Sports Phys Ther. 1993;18:365378. PubMed ID: 8348138 doi:10.2519/jospt.1993.18.1.365

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Ubinger ME, Prentice WE, Guskiewicz KM. Effect of closed kinetic chain training on neuromuscular control in the upper extremity. J Sports Rehabil. 1999;8:184194. doi:10.1123/jsr.8.3.184

    • Crossref
    • Search Google Scholar
    • Export Citation
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