Konda Shoji, Yanai Toshimasa, Sakurai Shinji
Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan.
Am J Sports Med. 2015 Oct;43(10):2445-51. doi: 10.1177/0363546515594379. Epub 2015 Aug 11.
The role of the scapula during high-velocity baseball pitching has been described without 3-dimensional kinematic data. It has been speculated that the scapula functions to align the humerus with the spine of the scapula on both the transverse and scapular planes at the end of the arm-cocking phase.
Two hypotheses were formulated: (1) the scapulothoracic protraction angle correlates with the humerothoracic horizontal adduction angle among participants, and (2) the scapulohumeral rhythm of the humerothoracic elevation is not the same as the normal ratio (2:1) observed widely in controlled abductions.
Descriptive laboratory study.
A total of 20 Japanese professional baseball pitchers were asked to pitch 3 fastballs as they would normally during pitching practice. The 3-dimensional kinematic data of the thorax, scapulae, humeri, and pelvis were recorded using an electromagnetic tracking device operating at 240 Hz. Humerothoracic, scapulothoracic, and glenohumeral joint configurations were determined at the instant of stride-foot contact (SFC) and the end of the arm-cocking phase (MER).
The mean (±SD) glenohumeral horizontal adduction (-6° ± 7°) and elevation (85° ± 10°) angles at the MER indicated that the humerus was positioned almost parallel to the spine of the scapula. The mean scapulothoracic protraction angle (15° ± 10°) was significantly correlated with the humerothoracic horizontal adduction angle (10° ± 11°) at the MER (r = 0.76, P < .001) but not at the SFC (r = 0.13, P = .58). The scapulohumeral rhythm (4.2 [±1.9]:1) expressed as the ratio of the glenohumeral elevation angle to the scapulothoracic upward rotation angle at the MER was significantly greater than the normal ratio (2:1) (P < .01).
The results supported the hypotheses, providing evidence to corroborate the widely accepted concept that the scapula functions to align the humerus with the spine of the scapula so as to limit the glenohumeral joint configuration within the "safe zone" at the MER.
Disruption of coordination, such as abnormal patterns including "SICK" scapula (scapular malposition, inferior medial border prominence, coracoid pain, and dyskinesis) and scapular dyskinesis, may result in an abnormal configuration of the glenohumeral joint at the MER.
肩胛骨在高速棒球投球过程中的作用此前是在缺乏三维运动学数据的情况下被描述的。据推测,在手臂后摆阶段结束时,肩胛骨在横断平面和肩胛平面上使肱骨与肩胛冈对齐。
提出了两个假设:(1)参与者中肩胛胸壁前伸角度与肱骨胸壁水平内收角度相关;(2)肱骨胸壁抬高时的肩肱节律与在控制性外展中广泛观察到的正常比例(2:1)不同。
描述性实验室研究。
20名日本职业棒球投手被要求像在投球练习中那样正常投出3个快球。使用运行频率为240Hz的电磁跟踪设备记录胸部、肩胛骨、肱骨和骨盆的三维运动学数据。在跨步脚着地瞬间(SFC)和手臂后摆阶段结束时(MER)确定肱骨胸壁、肩胛胸壁和盂肱关节的构型。
MER时盂肱关节水平内收(-6°±7°)和抬高(85°±10°)角度的平均值表明,肱骨几乎与肩胛冈平行。MER时肩胛胸壁前伸角度的平均值(15°±10°)与肱骨胸壁水平内收角度(10°±11°)显著相关(r = 0.76,P <.001),但在SFC时不相关(r = 0.13,P =.58)。以MER时盂肱关节抬高角度与肩胛胸壁向上旋转角度之比表示的肩肱节律(4.2[±1.9]:1)显著大于正常比例(2:1)(P <.01)。
结果支持了假设,为广泛接受的概念提供了证据,即肩胛骨的功能是使肱骨与肩胛冈对齐,以便在MER时将盂肱关节构型限制在“安全区”内。
协调性破坏,如包括“病态”肩胛骨(肩胛骨位置异常、下内侧缘突出、喙突疼痛和运动障碍)和肩胛运动障碍等异常模式,可能导致MER时盂肱关节构型异常。