Rehabilitation of the shoulder offers many challenges. Arthroscopic and advanced imaging techniques have facilitated significant changes in our perception and management of glenoid labral pathology. Despite this progress, controversies involving the glenoid labrum continue to exist. This paper presents an overview of glenoid labral histology, morphology, and vascularity. Labral injuries are investigated and categorized. The management of glenoid labral pathology is discussed along with ramifications for shoulder rehabilitation.
Mary Taylor, Stacie Fruth and Sam Kegerreis
Thomas Zmierski, Sam Kegerreis and James Scarpaci
The purposes of this study were (a) to determine the reliability of the Nicholas hand-held dynamometer for measuring scapular adductor strength and (b) to determine if isokinetic strengthening of the scapular adductors while horizontally abducting the shoulder is more effective than strengthening the scapular adductors while extending the shoulder. An isometric make test was used to determine scapular adductor strength before and after a 6-week training program. Intraclass correlation coefficient indicated high pretest and posttest reliability. The individuals who trained the scapular adductors while horizontally abducting the shoulder showed greater increases in mean force values (20.49 kg pretest to 31.74 kg posttest) than the group combining scapular adduction with shoulder extension (19.61 kg pretest and 25.52 kg posttest). ANOVA showed a significant interaction between group and time. It may be more effective to isokinetically strengthen the scapular adductors with shoulder horizontal abduction rather than shoulder extension as a combined movement.
Robert L. Whalen, Steven P. Konstant, Teddy W. Worrell and Sam Kegerreis
The purpose of this study was to determine whether differences exist in EMG activity between involved and uninvolved upper trapezius muscles in participants with unilateral neck pain. Thirteen volunteers, seen by a physical therapist, gave informed consent. Surface EMG electrodes were placed on involved and uninvolved upper trapezius muscles. Root mean squared EMG activity was measured. Visual analog scales (VASs) for pain were used for each side. Reliability data indicated high ICC (2,1) but also large SEMs and CVs. EMG activity increased from resting to shrugging to abducting positions. Participants perceived greater pain on the involved side than the uninvolved side. EMG readings for individuals were consistent, however, between participants. EMG had high variability. Although participants' VAS scores were consistent with their reports of unilateral neck pain, surface EMG readings did not support the existence of increased muscle activity on the involved side.