Glenohumeral joint: internal and external rotation range of motion in javelin throwers

Sport Science and Medicine Centre, Manchester Metropolitan University, Crewe and Alsager Faculty, Stoke on Trent, United Kingdom.
British Journal of Sports Medicine (Impact Factor: 5.03). 09/1998; 32(3):226-8. DOI: 10.1136/bjsm.32.3.226
Source: PubMed


To assess differences in glenohumeral joint rotatory range of movement in javelin throwers between the throwing and non-throwing arm.
A universal 360 degrees goniometer was used to assess glenohumeral joint external and internal rotation range in 90 degrees of shoulder abduction in a group of ten senior international javelin throwers.
Both arms had significantly greater degrees of external than internal rotation (p < 0.01), and the throwing arm had significantly greater range of external rotation than the non-throwing arm (p < 0.01).
The presence of an excessive range of external rotation in the throwing shoulder has the potential to increase eccentric load on the rotator cuff muscles and strain on the passive restraints of the glenohumeral joint. Both of these factors have been implicated in the pathological processes leading to injury in the overhead throwing athlete.

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    • "The differences between the findings may be related to the nature of the sports. Overhead throwing athletes have been shown to have increased range of external rotation (Herrington, 1998) as a result of repetitive deformation of the anterior/inferior capsule with the commensurate changes in muscle and capsule length it is believed that this could affect the mechanoreceptors of these tissues resulting in partial de-afferentiation and proprioceptive deficit (Myers et al., 2006). "
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    Physical therapy in sport: official journal of the Association of Chartered Physiotherapists in Sports Medicine 02/2010; 11(1):18-22. DOI:10.1016/j.ptsp.2009.10.001 · 1.65 Impact Factor
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    • "This was measured from the neutral position for rotation (i.e. lying supine, with 908 glenohumeral abduction, elbow flexed to 908, and the forearm vertical) (Herrington, 1998). Medial rotation of left shoulderZ508 † Very weak posterior rotator cuff muscles in eccentric outer range; rightOleft. "
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    Physical Therapy in Sport 05/2005; 6(2). DOI:10.1016/j.ptsp.2005.01.003 · 1.65 Impact Factor
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    • "Não foram encontradas diferenças entre a amplitude de rotação externa dos dois braços em estudos realizados com tenistas (Ellenbecker et al., 2002) e com jogadores de voleibol (Wang et al., 2000). No entanto, a maioria dos estudos realizados com tenistas demonstraram maior amplitude de rotação externa no ombro dominante em comparação com o ombro não dominante (Kibler, Chandler, Livingston, Roetert, 1996; Ellenbecker & Roetert, 2002), tendo a mesma tendência sido verificada com lançadores do dardo (Herrington, 1998) e lançadores do basebol (Brown et al., 1988; Bigliani, Codd, Connor, Levine, Littlefield, Hershon, 1997; Crockett, Gross, Wilk et al., 2002). A grande amplitude de rotação externa nestes atletas é expectável e é uma consequência natural da estrutura mecânica das acções de lançar. "
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    ABSTRACT: Resumo O principal objectivo do presente artigo é caracterizar o perfil muscular em termos de força/mobilidade dos músculos envolvidos na rotação do ombro em atletas praticantes de acções de lançamento. Os lançamentos constituem uma família de gestos técnicos desportivos muito comum. A grande mobilidade do ombro e a amplitude, intensidade e natureza repetitiva dos seus movimentos nas acções de lançamento aumenta o risco de lesão. Assim, nestes atletas é necessário encontrar um compromisso entre mobilidade e potência no ombro e estabilidade funcional. Por outras palavras, é necessário garantir um equilíbrio adequado entre os músculos rotadores internos e os seus antagonistas, os músculos rotadores externos, principalmente os músculos da coifa dos rotadores. O ratio entre a força de rotação externa e a força de rotação interna (RE:RI ratio), medida em dinamómetros isocinéticos, e a amplitude de movimento, medida por goniometria, em atletas de diferentes desportos são apresentados e discutidos. Os valores de RE:RI ratio observados no ombro dominante de praticantes de acções de lançamento são normalmente mais baixos que os valores de referência, e isso depende de um aumento da força de rotação interna sem aumentos correspondentes na força de rotação externa. Em relação à amplitude de movimentos, o ombro dominante desses atletas apresenta maior amplitude de rotação externa, e uma redução na amplitude de rotação interna e de rotação total. Essas adaptações predispõem o atleta para instabilidade do ombro e aumentam o risco de lesão. O fortalecimento e o desenvolvimento da capacidade de alongamento destes músculos devem constituir premissas que contribuam para a gestão de um binómio mobilidade/estabilidade articular mais adequado às exigências do ombro de um atleta que repetirá muitas acções de lançar na sua carreira desportiva. Abstract The main purpose of this article is to characterize the shoulder rotator muscle profile (the strength/mobility characteristics) in overarm throwing athletes. The overarm throw is a very common pattern in several sports. The great mobility of the shoulder joint and the amplitude, intensity and repetitive nature of its motion in overarm skills lead to a high risk of injury. In these athletes it is necessary to find a compromise between shoulder mobility and power and functional stability. In other words, it is essential to guarantee an adequate balance between the internal rotator muscles accelerating the arm and their antagonists, the external rotator muscles. The ratio between the external and internal rotation force (RE:RI ratio), measured through isokinetic dynamometer, and the range of motion (ROM), measured through goniometry, in athletes from different sports, are presented and discussed. The values of RE:RI ratio observed in the dominant shoulder of overarm athletes are usually lower, and this is dependent on an increase in the arm internal rotation strength without changes of the same magnitude in the external rotation strength. Concerning the ROM, the dominant shoulder in overarm athletes presents higher ROM of external rotation, and a decrease in the ROM of internal rotation and in the total rotation arc. These adaptations predispose the athlete to shoulder instability and injury. Specific exercises for stretching and strength development of the external rotator muscles are fundamental to the shoulder balance necessary for injury prevention, since these athletes will perform massive repetitions of ballistic movements of shoulder internal rotation during their sport career.
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