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上肢运动过程中的肩部肌肉募集模式及相关生物力学

Shoulder muscle recruitment patterns and related biomechanics during upper extremity sports.

作者信息

Escamilla Rafael F, Andrews James R

机构信息

Andrews-Paulos Research and Education Institute, Gulf Breeze, Florida, USA.

出版信息

Sports Med. 2009;39(7):569-90. doi: 10.2165/00007256-200939070-00004.

Abstract

Understanding when and how much shoulder muscles are active during upper extremity sports is helpful to physicians, therapists, trainers and coaches in providing appropriate treatment, training and rehabilitation protocols to these athletes. This review focuses on shoulder muscle activity (rotator cuff, deltoids, pectoralis major, latissimus dorsi, triceps and biceps brachii, and scapular muscles) during the baseball pitch, the American football throw, the windmill softball pitch, the volleyball serve and spike, the tennis serve and volley, baseball hitting, and the golf swing. Because shoulder electromyography (EMG) data are far more extensive for overhead throwing activities compared with non-throwing upper extremity sports, much of this review focuses on shoulder EMG during the overhead throwing motion. Throughout this review shoulder kinematic and kinetic data (when available) are integrated with shoulder EMG data to help better understand why certain muscles are active during different phases of an activity, what type of muscle action (eccentric or concentric) occurs, and to provide insight into the shoulder injury mechanism. Kinematic, kinetic and EMG data have been reported extensively during overhead throwing, such as baseball pitching and football passing. Because shoulder forces, torques and muscle activity are generally greatest during the arm cocking and arm deceleration phases of overhead throwing, it is believed that most shoulder injuries occur during these phases. During overhead throwing, high rotator cuff muscle activity is generated to help resist the high shoulder distractive forces approximately 80-120% bodyweight during the arm cocking and deceleration phases. During arm cocking, peak rotator cuff activity is 49-99% of a maximum voluntary isometric contraction (MVIC) in baseball pitching and 41-67% MVIC in football throwing. During arm deceleration, peak rotator cuff activity is 37-84% MVIC in baseball pitching and 86-95% MVIC in football throwing. Peak rotator cuff activity is also high is the windmill softball pitch (75-93% MVIC), the volleyball serve and spike (54-71% MVIC), the tennis serve and volley (40-113% MVIC), baseball hitting (28-39% MVIC), and the golf swing (28-68% MVIC). Peak scapular muscle activity is also high during the arm cocking and arm deceleration phases of baseball pitching, with peak serratus anterior activity 69-106% MVIC, peak upper, middle and lower trapezius activity 51-78% MVIC, peak rhomboids activity 41-45% MVIC, and peak levator scapulae activity 33-72% MVIC. Moreover, peak serratus anterior activity was approximately 60% MVIC during the windmill softball pitch, approximately 75% MVIC during the tennis serve and forehand and backhand volley, approximately 30-40% MVIC during baseball hitting, and approximately 70% MVIC during the golf swing. In addition, during the golf swing, peak upper, middle and lower trapezius activity was 42-52% MVIC, peak rhomboids activity was approximately 60% MVIC, and peak levator scapulae activity was approximately 60% MVIC.

摘要

了解上肢运动过程中肩部肌肉何时以及何种程度地活跃,有助于医生、治疗师、体能教练和教练为这些运动员提供适当的治疗、训练和康复方案。本综述聚焦于棒球投球、美式橄榄球传球、风车式垒球投球、排球发球和扣球、网球发球和截击、棒球击球以及高尔夫挥杆过程中的肩部肌肉活动(肩袖肌群、三角肌、胸大肌、背阔肌、肱三头肌和肱二头肌以及肩胛部肌肉)。由于与非投掷类上肢运动相比,过头投掷活动的肩部肌电图(EMG)数据要丰富得多,因此本综述的大部分内容聚焦于过头投掷动作中的肩部EMG。在本综述中,肩部运动学和动力学数据(如有)与肩部EMG数据相结合,以帮助更好地理解为何某些肌肉在活动的不同阶段活跃,发生何种类型的肌肉动作(离心或向心),并深入了解肩部损伤机制。在过头投掷过程中,如棒球投球和橄榄球传球,运动学、动力学和EMG数据已有广泛报道。由于在过头投掷的手臂预摆和手臂减速阶段,肩部力量、扭矩和肌肉活动通常最大,因此人们认为大多数肩部损伤发生在这些阶段。在过头投掷过程中,在手臂预摆和减速阶段会产生较高的肩袖肌群肌肉活动,以帮助抵抗约为体重80 - 120%的高肩部牵张力量。在手臂预摆阶段,棒球投球时肩袖肌群的峰值活动为最大自主等长收缩(MVIC)的49 - 99%,橄榄球传球时为41 - 67% MVIC。在手臂减速阶段,棒球投球时肩袖肌群的峰值活动为37 - 84% MVIC,橄榄球传球时为86 - 95% MVIC。肩袖肌群的峰值活动在风车式垒球投球(75 - 93% MVIC)、排球发球和扣球(54 - 71% MVIC)、网球发球和截击(40 - 113% MVIC)、棒球击球(28 - 39% MVIC)以及高尔夫挥杆(28 - 68% MVIC)中也很高。在棒球投球的手臂预摆和手臂减速阶段,肩胛部肌肉的峰值活动也很高,前锯肌的峰值活动为69 - 106% MVIC,上、中、下斜方肌的峰值活动为51 - 78% MVIC,菱形肌的峰值活动为41 - 45% MVIC,肩胛提肌的峰值活动为33 - 72% MVIC。此外,在风车式垒球投球过程中,前锯肌的峰值活动约为60% MVIC,在网球发球以及正手和反手截击过程中约为75% MVIC,在棒球击球过程中约为30 - 40% MVIC,在高尔夫挥杆过程中约为70% MVIC。另外,在高尔夫挥杆过程中,上、中、下斜方肌的峰值活动为42 - 52% MVIC,菱形肌的峰值活动约为60% MVIC,肩胛提肌的峰值活动约为60% MVIC。

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