Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.
J Shoulder Elbow Surg. 2018 Jul;27(7):1214-1220. doi: 10.1016/j.jse.2018.02.037. Epub 2018 Mar 27.
Pectoralis minor tightness may be seen in individuals with scapular dyskinesis, and stretching is used for the treatment of altered scapular motion in sports and clinical fields. However, few researchers have reported on the effects of pectoralis minor stiffness on scapular motion during arm elevation. This study investigated whether an acute decrease of pectoralis minor stiffness after stretching changes the scapular motion during arm elevation.
The study allocated 15 dominant and 15 nondominant upper limbs in healthy men as control and interventional limbs, respectively. In the intervention limb group, the shoulder was passively and horizontally abducted at 150° of elevation for 5 minutes to stretch the pectoralis minor muscle. Before and after stretching, an electromagnetic sensor was used to examine 3-dimensional scapular motion during abduction and scaption. Ultrasonic shear wave elastography was used to measure pectoralis minor stiffness before and immediately after stretching and after arm elevation.
In the interventional limb, pectoralis minor stiffness decreased by 3.2 kPa immediately after stretching and by 2.5 kPa after arm elevation. The maximal changes in scapular kinematics after stretching were 4.8° of external rotation and 3.3° of posterior tilt in abduction, and 4.5° of external rotation and 3.7° of posterior tilt in scaption. Upward rotation in abduction or scaption did not change.
Stretching for the pectoralis minor muscle increases external rotation and posterior tilt of the scapula during arm elevation.
肩胛带运动障碍患者可能存在胸小肌紧张,在运动和临床领域,常通过拉伸来治疗肩胛运动改变。然而,很少有研究报道胸小肌僵硬对上肢抬高时肩胛运动的影响。本研究旨在探讨拉伸后胸小肌僵硬程度的急性降低是否会改变上肢抬高时的肩胛运动。
本研究将 15 名健康男性的优势侧和非优势侧上肢分别分配为对照组和干预组。在干预组中,肩部被动水平外展至 150°,持续 5 分钟以拉伸胸小肌。在拉伸前后,使用电磁传感器检测外展和内收时的三维肩胛运动。在拉伸前、后和上肢抬高后,使用超声剪切波弹性成像测量胸小肌僵硬度。
在干预组中,拉伸后胸小肌僵硬度立即降低 3.2kPa,上肢抬高后降低 2.5kPa。拉伸后肩胛运动学的最大变化为外展时外旋 4.8°、后倾 3.3°,内收时外旋 4.5°、后倾 3.7°。外展或内收时的上旋没有改变。
拉伸胸小肌可增加上肢抬高时的肩胛骨外旋和后倾。