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Keramat Ullah Keramat and Mohammad Naveed Babar

is reported with maximum electromyographic activity in resisted tasks above 120° of overhead movement in all planes. 1 , 2 Recognition of the 3 parts and their relative role is important for exercise programs and stretching for the prevention and rehabilitation of shoulder pathologies. The 3

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Jamon Couch, Marc Sayers, and Tania Pizzari

In the overhead athlete, there is evidence that imbalance between internal (IR) and external rotation (ER) strength, either reported as absolute measures or a ratio between the 2, increases the risk of sustaining a shoulder injury. 1 The ability to accurately and effectively measure and monitor

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Max C. Stuelcken, René E.D. Ferdinands, Karen A. Ginn, and Peter J. Sinclair

This preliminary study aimed to quantify the magnitude of the peak shoulder distraction force during the bowling action of female cricket fast bowlers. An eight camera Vicon motion analysis system operating at 120 Hz recorded the fast bowling actions of 18 Australian female fast bowlers. A three segment inverse solution model of the bowling arm was used to calculate the shoulder distraction force. A large peak shoulder distraction force was recorded during the early stages of the follow-through of the bowling action. When normalized for body weight, the distraction force was within the range of values reported for baseball and softball pitchers, who are considered to be at high risk of shoulder injury. Therefore, the relative importance of the peak shoulder distraction force in the fast bowling action for the development of shoulder pain in female cricket fast bowlers warrants further investigation.

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Pascal Edouard, Pierre Samozino, Marc Julia, Sophie Gleizes Cervera, William Vanbiervliet, Paul Calmels, and Vincent Gremeaux


Isokinetic assessment of shoulder internal- (IR) and external-rotator (ER) strength is commonly used with many different postures (sitting, standing, or supine) and shoulder positions (frontal or scapular plane with 45° or 90° of abduction).


To conduct a systematic review to determine the influence of position on the intersession reliability of the assessment of IR and ER isokinetic strength, to identify the most reliable position, and to determine which isokinetic variable appears to be most stable in intersession reliability.

Evidence Acquisition:

A systematic literature search through MEDLINE and Pascal Biomed databases was performed in October 2009. Criteria for inclusion were that studies be written in English or French, describe the isokinetic evaluation methods, and describe statistical analysis.

Evidence Synthesis:

Sixteen studies meeting the inclusion criteria were included. Variable reliability of ER and IR peak torque (PT) were generally reported for all assessment positions; intraclass correlation coefficients were .44–.98 in the seated position with 45° of shoulder abduction, .09–.77 in the seated position with 90° of shoulder abduction, .86–.99 (coefficient of variation: 7.5–29.8%) in the supine position with 90° of shoulder abduction, .82–.84 in the supine position with 45° of shoulder abduction, and .75–.94 in standing. The ER:IR ratio reliability was low for all positions.


The seated position with 45° of shoulder abduction in the scapular plane seemed the most reliable for IR and ER strength assessment. The standing position or a shoulder posture with 90° of shoulder abduction or in the frontal plane must be used with caution given the low reliability for peak torque. Good reliability of ER and IR PT was generally reported, but ER:IR ratio reliability was low.

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Hio Teng Leong and Siu Ngor Fu

Rotator cuff (RC) tendinopathy is considered to be the principal cause of shoulder pain in orthopedics and sports medicine, 1 , 2 particularly in athletes with repetitive overhead activities. 3 It is an umbrella term that includes a spectrum of pathological changes ranging from tendinopathy to

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Oliver A. Silverson, Gaura Saini, Kyle R. Knutson, Briana D. Sauder, Gregory R. Sheldon, Allison F. Willwerscheid, Chelsea L. Gruber, Fanchon Ohlrogge, Bradley J. Nelson, and Justin L. Staker

Adaptations in upper-extremity movement characteristics are prevalent in overhead athletes. For example, increased glenohumeral joint laxity is commonly found in the shoulders of competitive swimmers, 1 – 3 while a “shift” in the range of motion (ROM) profile in the dominant shoulders of baseball

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Elshan Najafov, Şeyda Özal, Ahmet Yiğit Kaptan, Coşkun Ulucaköy, Ulunay Kanatlı, Baybars Ataoğlu, and Selda Başar

The role of biceps long head (LHB) as a pain generator has been well documented in the literature. 1 , 2 Shoulder arthroscopy leads to better definitions of LHB intra-articular part and variations. 3 Major biceps long head pathologies are instability, primary or secondary biceps tendinitis

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Bryan R. Picco, Meghan E. Vidt, and Clark R. Dickerson

Shoulder pain in the general population has a lifetime prevalence of 66.7% 1 and scapular movement is an important determinant of shoulder injury. 2 The role of scapular dyskinesis as a cause or symptom of shoulder dysfunction is unknown. 3 , 4 Identifying underlying pathology requires normative

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Jin Hyuck Lee, Ji Soon Park, and Woong Kyo Jeong

Key Points ▸ Scapular dyskinesis can be caused by isolated hypertrophy of the serratus anterior, not only the weakness of the serratus anterior and trapezius. ▸ Bilateral shoulder computed tomography seems to be needed in patients with abnormal scapular movement and periscapular muscle spasm to

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Margaret A. Finley, Elizabeth Euiler, Shivayogi V. Hiremath, and Joseph Sarver

frequently compared with the occupational matched control who did not use a manual wheelchair. 2 Dependency on upper extremities for most activities of daily living and mobility predisposes these individuals to overuse and is associated with the development of shoulder pain in a high percentage (70%) of