Torres Renato Rangel, Gomes João Luiz Ellera
School of Medicine, Universidade Federal do Rio Grande do Sul, Brazil.
Am J Sports Med. 2009 May;37(5):1017-23. doi: 10.1177/0363546508329544. Epub 2009 Mar 4.
Glenohumeral internal rotation deficit, often diagnosed in players of overhead sports, has been associated with the development of secondary shoulder lesions.
Asymptomatic players of different overhead sports will exhibit variable degrees of glenohumeral internal rotation deficit.
Cross-sectional study; Level of evidence, 3.
Fifty-four asymptomatic male volunteers (108 shoulders) divided into 3 groups (tennis players, swimmers, control group) underwent measurements of glenohumeral internal and external rotation using clinical examination with scapular stabilization. Measurements of dominant and nondominant shoulders were compared within and between groups. Glenohumeral internal rotation deficit (GIRD) was defined as the difference in internal rotation between the nondominant and dominant shoulders.
In tennis players, mean GIRD was 23.9 degrees +/- 8.4 degrees (P < .001); in swimmers, 12 degrees +/- 6.8 degrees (P < .001); and in the control group, 4.9 degrees +/- 7.4 degrees (P = .035). Dominant shoulders showed significant difference between all groups, and the difference in internal rotation of the dominant shoulder between the group of tennis players in comparison with the control group (27.6 degrees, P < .001) was greater than the difference in internal rotation of the dominant shoulder found in the group of swimmers compared with the control group (17.9 degrees, P < .001). Between tennis players and swimmers, the difference in internal rotation of the dominant shoulder was 9.7 degrees (P = .002).
Dominant limbs showed less glenohumeral internal rotation than the nondominant limbs in all groups, with the deficit in the group of tennis players about twice the deficit found for swimmers. Mean difference between limbs in the control group was less than 5 degrees, which is within normal parameters according to most studies. There were statistically significant differences between all groups when dominant shoulders were compared with each other, differences that were not compensated by external rotation gain. Tennis players had the least range of motion, followed by swimmers.
盂肱关节内旋不足常见于从事过头运动的运动员,与继发性肩部损伤的发生有关。
不同过头运动项目的无症状运动员会表现出不同程度的盂肱关节内旋不足。
横断面研究;证据等级,3级。
54名无症状男性志愿者(108个肩部)分为3组(网球运动员、游泳运动员、对照组),采用肩胛稳定的临床检查方法测量盂肱关节的内旋和外旋。比较组内和组间优势肩与非优势肩的测量结果。盂肱关节内旋不足(GIRD)定义为非优势肩与优势肩内旋角度的差值。
网球运动员的平均GIRD为23.9°±8.4°(P <.001);游泳运动员为12°±6.8°(P <.001);对照组为4.9°±7.4°(P =.035)。所有组间优势肩均存在显著差异,网球运动员组与对照组优势肩的内旋差异(27.6°,P <.001)大于游泳运动员组与对照组优势肩的内旋差异(17.9°,P <.001)。网球运动员组与游泳运动员组优势肩的内旋差异为9.7°(P =.002)。
所有组中优势肢体的盂肱关节内旋均小于非优势肢体,网球运动员组的不足约为游泳运动员组的两倍。对照组肢体间的平均差异小于5°,根据大多数研究,这在正常范围内。当比较优势肩时,所有组间均存在统计学显著差异,且这些差异未被外旋增加所代偿。网球运动员的活动范围最小,其次是游泳运动员。