scapulohumeral rhythm, is needed for efficient arm movement and allows for glenohumeral alignment to maximize joint stability. 2 Scapular mobilization combined with end range glenohumeral mobilization may be an effective and efficient conservative treatment option to improve the symptoms associated with
Kevin Laudner and Kyle Thorson
coracoid process away from the rib cage 6 , 12 – 14 via glenohumeral horizontal abduction. Unfortunately, this gross stretch may place unwanted stress on the anterior capsuloligamentous structures. Therefore, subsequent lengthening techniques should also be incorporated and at times, substituted; however
Daniel C. McFarland, Alexander G. Brynildsen and Katherine R. Saul
In vivo glenohumeral joint motion involves not only rotation, but also translation 1 ; modeling this mobile joint is challenging. Many musculoskeletal models neglect translation, representing the joint as a ball-and-socket. 2 – 4 This assumption makes the modeled joint inherently stable; however
Jeffrey G. Williams, Lauryn Darnall and Conrad Schumann
Key Points ▸ Spinal range of motion among players is suspected to be compensatory to tightness in the posterior shoulder. ▸ No studies have tested this relationship. ▸ No relationship was observed between thoracolumbar and glenohumeral ranges of motion. Throwing a baseball demands properly
Posterior glenohumeral dislocations are rare, comprising only 4 percent of all shoulder dislocations. While early and accurate diagnosis of a posterior dislocation increases the likelihood of success with non-operative management, traditional rehabilitation may not adequately address the sensorimotor deficits that are evident following dislocation. Restoration of the sensorimotor system is critical to successfully return a throwing athlete safely to sports. The use of functional neuromuscular rehabilitation (FNR) attempts to address deficits in the compromised sensorimotor system. With a good understanding of the specific demands placed on the overhead athlete’s shoulder, knowledge of glenohumeral and scapulothoracic joints’ biome-chanics, respect for the athlete’s level of symptoms and pain, adherence to soft tissue healing, and application of a rehabilitation program that incorporates FNR, an athlete can successfully return to a high level of competition following an acute posterior glenohumeral dislocation.
Matthew Rivera, Lindsey Eberman, Kenneth Games and Cameron J. Powden
PM length can influence the position and the motion of the scapula. 3 , 4 By altering scapular positioning, patients with a restricted PM length may not demonstrate the necessary accessory motion from the scapulothoracic joint to achieve full glenohumeral total arc of motion (TAM). 2 , 3 Thus, once
dyskinesis is associated with bony, joint, neurological, and soft tissue factors. 1 Bony factors include thoracic kyphosis and clavicular impairments including postfracture malunion. 1 Instability of both the AC joint and glenohumeral joint, and cartilage degeneration are known joint factors in the cause
Sally A. Perkins and John E. Massie
To determine whether patients were satisfied after thermal shrinkage on the capsule of the glenohumeral joint (GHJ).
Design and Setting:
The affected shoulder was assessed preoperatively and 2 months postoperatively. The assessment evaluated pain on activities of daily living (ADLs), physical activity level, satisfaction with shoulder function, and a modified UCLA pain scale.
Eight athletes, 4 men and 4 women, with a mean age of 21 years, participated. Each had sustained a traumatic injury to the GHJ resulting in multidirectional instability.
Subjects were evaluated preoperatively and 2 months postoperatively for GHJ laxity and labral deformity. Goniometric measurements of flexion/extension, abduction/adduction, and internal/external rotation of the GHJ were completed.
Six of the 8 subjects had reduced pain. Active extension increased significantly in 7. ADLs were all improved. All 8 subjects were satisfied with the thermal-shrinkage procedure.
Thermal shrinkage of the capsule of the GHJ results in patient satisfaction and reduced pain.
Jun Sagano, David Magee and Masaki Katayose
Glenohumeral and scapular upward rotation are important factors in functional upper extremity motion.
To determine how different amounts of glenohumeral rotation (internal, external, and neutral) affect scapular upward rotation.
Controlled laboratory study. Independent variables were the amounts of internal, external, and neutral glenohumeral rotation. The dependent variable was the amount of scapular upward rotation.
40 subjects who were right-hand dominant, sedentary, and age 16 to 35 years.
Main Outcome Measures:
An inclinometer assessed scapular upward rotation with the 3 different positions of glenohumeral rotation in each 0°, 30°, 60°, and 90° of humeral elevation in the scapular plane.
Scapular upward rotation tended to increase with glenohumeral internal and external rotation, compared with neutral rotation in each degree of humeral elevation. This trend was seen on both right and left sides.
Scapular upward rotation at different levels of humeral elevation in the scapular plane was affected by the positions of glenohumeral rotation.
David W. Keeley, Gretchen D. Oliver, Christopher P. Dougherty and Michael R. Torry
The purpose of this study was to better understand how lower body kinematics relate to peak glenohumeral compressive force and develop a regression model accounting for variability in peak glenohumeral compressive force. Data were collected for 34 pitchers. Average peak glenohumeral compressive force was 1.72% ± 33% body weight (1334.9 N ± 257.5). Correlation coefficients revealed 5 kinematic variables correlated to peak glenohumeral compressive force (P < .01, α = .025). Regression models indicated 78.5% of the variance in peak glenohumeral compressive force (R2 = .785, P < .01) was explained by stride length, lateral pelvis flexion at maximum external rotation, and axial pelvis rotation velocity at release. These results indicate peak glenohumeral compressive force increases with a combination of decreased stride length, increased pelvic tilt at maximum external rotation toward the throwing arm side, and increased pelvis axial rotation velocity at release. Thus, it may be possible to decrease peak glenohumeral compressive force by optimizing the movements of the lower body while pitching. Focus should be on both training and conditioning the lower extremity in an effort to increase stride length, increase pelvis tilt toward the glove hand side at maximum external rotation, and decrease pelvis axial rotation at release.