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Source publication
Background:
The posterior shoulder muscles play key roles in maintaining shoulder function in throwing. Arm fatigue has been identified as a risk factor for shoulder and elbow pain in youth baseball pitchers. However, endurance of the posterior shoulder muscles in overhead athletes is not routinely examined or conditioned.
Hypothesis:
Upper extrem...
Context in source publication
Context 1
... same concerns apply to the shoulder, so a cadence to control arm motion and a mechanical block were used to prevent placing the shoulder in excessive hyperabduction. During the PSET, the participant was positioned prone, with the test shoulder off the table and the arm perpendicular to the floor ( Figure 1). A quick-grip mini- bar clamp (546ZR, IRWIN, Quick-Grip tools, Wilmington, Ohio) was adjusted for each patient and fixed at the point that the participant's shoulder reached 90° of horizontal abduction, the point at which the participant was to hold the arm at the top of the arc of motion for 1 second. ...
Similar publications
Background:
Little League throwing guidelines have recently been implemented in an attempt to lessen the growing number of elbow injuries occurring in youth baseball players.
Hypothesis/purpose:
The purpose of this study was to examine pre- and postseason changes seen on magnetic resonance imaging (MRI) in youth baseball players' elbows in an at...
Citations
... Therefore, it is needed to delay or avoid the ER fatigue that induces neuromuscular changes to reduce the risk of injury. To achieve this purpose, the optimal treatment strategy is muscular endurance training of the external rotators, as Moore et al. demonstrated that high school-aged baseball players increased their posterior shoulder endurance by completing a 20-week training program [15]. ...
Muscle synergy is a state-of-the-art method for quantifying motor control with multichannel electromyographic (EMG) recordings. Muscle synergies have been used in many sports-related applications, including swimming, baseball, basketball, and other sports, for a biomechanical description of sports movements, improving athlete performance, preventing injuries, and promoting synergy-based rehabilitation strategies. However, despite the fact that it is clear that, in many sports, the assessments based on multi-muscle analysis are crucial for performance, the practical impact of muscle synergies on sports practice has been quite limited. Thus, so far, the potential of muscle synergy in sports has been poorly explored. However, recent advancements in synergistic models may strongly impact the understanding of motor control in sports. We identified several margins for improvement, which include novel models and updated algorithms: the separation of the EMG components (phasic and tonic) leading repertoires of synergies for motion and holding posture; the choice of multiple synergistic models (spatial/temporal/time-varying and others); the connection of synergies with the task space and the consequent role of non-linearities; the use of computational models and digital twins; and the fields and sports in which synergies can be applied. In this narrative review, we discuss how the novel findings from the biomedical field may fill the gap in the literature for the extensive use of muscle synergies in sports with several applicative examples.
... A metronome set to 60 Hz was then used to standardize the test, whereby the subject was instructed to raise their arm on the first beat, hold it in 90° abduction for the next beat, and then lower it to the starting position on the third beat. The test was terminated when any of the following termination criteria were met [32]: ...
... (7)Raising the other arm.(8) The subject stated that they could not continue[32]. ...
Background and Objectives: This study focused on the impact of mental fatigue induced by motor imagery on upper limb function, an area with limited research compared to lower limb performance. It aimed to explore how diaphragmatic breathing exercises influence these effects. Materials and Methods: This study included 30 participants, and Group 1 participated in 12 sessions of diaphragmatic breathing exercises under the supervision of a physiotherapist; Group 2 did not receive any intervention. For all the participants, mental fatigue was induced with motor imagery before and after the intervention, and evaluations were performed before and after mental fatigue. Upper extremity functions were evaluated using isometric elbow flexion strength, hand grip strength, upper extremity reaction time and endurance, finger reaction time, the nine-hole peg test, shoulder position sense, light touch-pressure threshold, and two-point discrimination. Results: The study results showed that after mental fatigue, there was a decrease in isometric elbow flexion strength, nondominant hand grip strength, and nondominant upper extremity endurance, and an increase in nondominant tactile sensation (p < 0.05). No changes were found in two-point discrimination , nine-hole peg test time, and position sense on either side (p > 0.05). The effect of mental fatigue on isometric elbow flexion strength and nondominant grip strength showed significant improvement following diaphragmatic breathing exercises (p < 0.05). Conclusions: This study found that mental fatigue from motor imagery can impact elbow flexion, hand grip strength, upper extremity endurance, and tactile sensitivity. Breathing exercises may help improve strength parameters affected by mental fatigue. It is crucial to consider these effects on upper extremity functions in rehabilitation programs.
... The Posterior Shoulder Endurance Test (PSET) (41) utilizes 2% of the performer's body weight as resistance while prone horizontal abduction is performed at a cadence of 30 beats per minute. The test is reported to have excellent test-retest reliability [intraclass correlation coefficient (ICC) =0.85], though this test has been described in a healthy cohort only (41). Similarly, another study (42) described fatigue testing with scaption, prone horizontal abduction at 100° and standing cable press with 5%, 3%, and 30% body weight, respectively. ...
... The implementation of resistance exercises, such as weightlifting, resistance bands, and medicine ball drills, offers athletes the opportunity to target and strengthen the muscle groups central to the throwing motion [11]. This targeted training cultivates the power, speed, and endurance necessary for generating forceful throws and maintaining consistency throughout the course of a game [13,14]. Moreover, resistance-based training provides a means to mitigate injury risk by reinforcing the stability and durability of joints involved in the complex throwing process [15]. ...
The aim of this systematic review is to assess the effects of structured resistance training programs on the throwing performance and injury risk of baseball players, irrespective of their age or sex. The literature search was carried out on 18/10/2023, utilizing databases that include PubMed, Scopus, and the Web of Science. Our inclusion criteria encompassed research involving baseball players of all ages and sex who had undergone resistance-based training interventions. For comparison, we considered active control groups, irrespective of their exposure to additional training programs. The outcomes under investigation were related to throwing performance (i.e., throwing velocity and accuracy) and injuries associated with throwing. In our review, we exclusively included studies with a two- or multi-arm design. We evaluated the risk of bias using the PEDro scale. Out of the initial pool of 509 studies, we carefully examined 27 full-text articles and ultimately selected and analyzed 16 studies for inclusion in our review. Out of the 12 studies that compared and presented the inferential statistics for the post-training effects of the experimental versus control groups, it was observed that 8 of these studies demonstrated a significantly more favorable impact of the experimental group on enhancing throwing velocity when compared to the control group. Out of the three studies that compared the experimental and control groups in terms of throwing accuracy, only one study showed a significant improvement in the experimental group compared to the control group after the intervention. In conclusion, this systematic review indicates that resistance-based training interventions appear to be effective in enhancing throwing velocity. However, the evidence regarding the efficacy of these interventions in improving throwing accuracy is less robust. It is worth noting that while some experimental conditions may lead to an increase in injury rates, there is limited data available on this aspect, with only a few studies reporting on this variable.
... It is noteworthy that, following the principle of specificity, improvements in muscle endurance seem to most pronounced in the muscle groups that have been specifically trained and evaluated. In this direction, Moore et al. [54] recruited adolescent baseball players with 8-10 years of experience in the sport, and submitted them to a 20-week RT focused on strengthening the shoulder muscles, occurring three times a week. For this purpose, the authors employed a stair-step progression that prioritized endurance over strength, by increasing repetitions with proper technique before increasing resistive load through elastic bands and weight room exercises. ...
The aim of this manuscript was to review the evidence regarding the risks, concerns, and efficacy of resistance training (RT) on measures related to muscular fitness and hypertrophic responses of youth athletes, while also establishing recommendations to assist the prescription of RT in this population.
PubMed and Google Scholar databases were searched for studies that met the following inclusion criteria: (a) published in English as a full-text manuscript or thesis; (b) inclusion of RT protocols lasting > 6 weeks; (c) involvement of youth individuals (≤ 19 years) engaged in sport modalities.
Twenty-nine studies assessing muscle strength, power and/or endurance in young athletes were identified; only one of these studies did not show significant improvements with RT, specifically in muscle power, but improvements were substantially heterogeneous across the studies. The literature is still inconclusive regarding the occurrence of muscle hypertrophy in response to RT among youth athletic population, but this was drawn from just seven studies in non-athletic populations. Injury rates among youth participants were low and less concerning in well-designed, progressed, supervised and technique-oriented RT programs.
RT is an effective method to improve muscular fitness-related measures in young athletes. The varying experimental designs across studies still represent an obstacle to the establishment of precise guidelines for RT prescription in this population. Nevertheless, some suggestions about RT frequency, resting interval, intensity and volume were elaborated in this review to assist coaches working with youth athletes to optimize muscular fitness-related measures gains.
... 11 Feijen et al. examined the association between endurance and pain in the posterior shoulder using the posterior shoulder muscle endurance test with high activation levels of the middle trapezius, lower trapezius, infraspinatus, and supraspinatus muscles. [25][26][27] They observed a negative correlation between pain and shoulder muscle endurance. 11 Integrating the results of this previous report with those of the present study, we infer that training to improve the muscular endurance of the middle and lower trapezius, supraspinatus, and infraspinatus while inhibiting the posterior deltoid activity among the posterior shoulder muscles is important for preventing shoulder pain. ...
... Strong evidence, moderate evidence, limited evidence, conflicting evidence, against an association, in favor of an association, unknown association, an * indicates this study found a significant difference in a subsample of their studied cohort. 50 involves an athlete laying prone on a plinth with their test arm hanging vertically off the side. The participant then raises their arm to 90° horizontal abduction with a dumbbell weighing approximately 2% of bodyweight, the participant repeats this until volitional exhaustion. ...
... The participant then raises their arm to 90° horizontal abduction with a dumbbell weighing approximately 2% of bodyweight, the participant repeats this until volitional exhaustion. 21,50 This exercise has been shown to elicit high levels of activation in trapezius, supraspinatus, and infraspinatus. 50 In their sample of competitive swimmers, Feijen et al. ...
... 21,50 This exercise has been shown to elicit high levels of activation in trapezius, supraspinatus, and infraspinatus. 50 In their sample of competitive swimmers, Feijen et al. 21 found for every one additional repetition the swimmer performed, their risk of shoulder pain decreased by 5%. ...
... 9 While this extensive ROM is beneficial, it can be accompanied by joint instability and an increased risk for injury. 3,[10][11][12][13][14][15] Shoulder injuries often result in pain, stiffness, and/or limited ROM, potentially compromising shoulder functions. 3,10-15 A healthy shoulder joint is important for overhead athletes, as exemplified by extensive literature related to the shoulder for baseball, softball, tennis, basketball, swimming, and other overhead-dominant sports. ...
... 18,19 Physical fitness and musculoskeletal preparticipation assessments are often required for tactical professions (firefighters, police, military, etc.) and athletes to ensure physical aptitude, improve physical training interventions, and aid injury surveillance. 4,7,13,14 Abundant musculoskeletal data (i.e., shoulder ROM) have been reported for such purposes in literature for various populations of athletes (i.e., overhead athletes). 16 what is considered normal in the general population. ...
The unpredictable environments firefighters face paired with biomechanically compromising shoulder movements, such as overhead and lifting movements, place this population at an increased risk for shoulder injury. The purpose of this study was to assess firefighter trainees’ bilateral shoulder range of motion (ROM) using the Dynamic Athletic Research Institute Motion system. Retrospective anthropometric and ROM data for 31 male firefighter trainees were analyzed. Firefighter trainees’ mean shoulder ROM for bilateral external rotation, internal rotation, and extension were lower than previously published values. External rotation demonstrated the lowest percentage of trainees within normal ROM (left—6.67%, right—16.67%). Noting the susceptibility of upper extremity injuries among firefighters, establishing baseline ROM measurements for reference may improve musculoskeletal evaluations, training interventions, and injury rehabilitation.
... T A B L E 4 (Continued) described in baseball players, 50 involves an athlete laying prone on a plinth with their test arm hanging vertically off the side. The participant then raises their arm to 90° horizontal abduction with a dumbbell weighing approximately 2% of bodyweight, the participant repeats this until volitional exhaustion. ...
... The participant then raises their arm to 90° horizontal abduction with a dumbbell weighing approximately 2% of bodyweight, the participant repeats this until volitional exhaustion. 21,50 This exercise has been shown to elicit high levels of activation in trapezius, supraspinatus, and infraspinatus. 50 In their sample of competitive swimmers, Feijen et al. ...
... 21,50 This exercise has been shown to elicit high levels of activation in trapezius, supraspinatus, and infraspinatus. 50 In their sample of competitive swimmers, Feijen et al. 21 found for every one additional repetition the swimmer performed, their risk of shoulder pain decreased by 5%. ...
Aim
To synthesize and assess the literature for shoulder pain and injury risk factors in competitive swimmers.
Design
Systematic review with best‐evidence synthesis.
Data Sources
CINHAL, SportDiscus, Scorpus, PubMed, and Embase databases from 1966 to April 30 2022.
Search and Inclusion
Cohort, cross‐sectional, and case–control studies investigating shoulder pain or injury risk factors in competitive swimmers were included. Quality of eligible studies were assessed using a modified Newcastle–Ottawa scale. Risk factors were divided into four categories: modifiable‐intrinsic, modifiable‐extrinsic, non‐modifiable, and other/secondary.
Results
Of 1356 studies identified, 24 full texts were evaluated for methodological quality, 22 met the criteria and were included in best evidence synthesis. There was no strong evidence supporting or refuting the association between 80 assessed variables and shoulder injury or pain. The swimmers' competitive level (nondirectional), and shoulder muscle recruitment profiles (e.g., increased activity of serratus anterior) exhibited moderate evidence supporting an association. Conversely, internal and external range of motion, middle finger back scratch test, training frequency, specialty stroke, height/weight, sex, and age all had moderate evidence opposing an association. Limited evidence was found for 58 variables, and conflicting for 8. The highest quality study (n = 201) suggested high acute‐to‐chronic workload ratio and reduced posterior shoulder strength endurance are associated with injury.
Conclusions
Due to the paucity of high‐quality studies, future prospective studies are needed to reevaluate known risk factor associations over exploring additional potential risk factors. Swimming practitioners should be aware of the nondirectional association of a swimmer's competitive level and pain, as squad changes could impact injury incidence. Moreover, swimmers experiencing shoulder pain may show increased activity in shoulder stabilizers during specific movements. Importantly, shoulder strength‐endurance may be the most clinically relevant modifiable intrinsic risk factor.
... 26 Furthermore, given that all these tests involve weight bearing on the upper extremity with the shoulder flexed approximately 90°they are more likely to result in a posterior shear force across the glenohumeral joint, 27 suggesting they may be less relevant for patients with anterior shoulder instability. 27 The shoulder endurance test 28 and the posterior shoulder endurance test 29 were designed to assess posterior rotator cuff endurance, which may be relevant for overhead athletes but is not specific for athletes with anterior shoulder instability. Finally, the athlete shoulder test which seems to place anteriorly directed forces on the abducted shoulder has yet to be validated and is also limited by the need for expensive measuring equipment. ...
Background
Performance-based tests for patients with anterior shoulder dislocation are lacking. This study determined the reliability and validity of the supine moving apprehension test designed to assess the ability to control anterior instability loads.
Methods
Thirty-six participants were recruited (18 healthy individuals, and 18 patients following anterior shoulder dislocation). Healthy participants performed the supine moving apprehension test on 2 separate occasions to determine test-retest reliability. Patients completed the supine moving apprehension test and the Western Ontario Shoulder Instability index before and 6 months after surgical stabilization of their shoulder. The presence of anterior apprehension was also documented post-operatively.
Results
The supine moving apprehension test demonstrated good test-retest reliability (intraclass correlation coefficient = 0.74−0.84). Patients performed 18−30 repetitions less than healthy individuals during the supine moving apprehension test ( P < 0.01). A strong correlation was found between supine moving apprehension test scores and Western Ontario Shoulder Instability post-operatively ( r = −0.74, P ≤ 0.01). Supine moving apprehension test scores significantly improved among patients following surgery ( P < 0.01). Patients with a negative apprehension test post-operatively performed the supine moving apprehension test significantly better than patients with a positive apprehension test ( P < 0.01).
Conclusions
The supine moving apprehension test is reliable and valid among patients with anterior shoulder dislocation and may serve to assess patients’ ability to control shoulder anterior instability loads.