Poploski Kathleen M, Picha Kelsey J, Winters Joshua D, Royer Scott D, Heebner Nicholas R, Lambert Brad, Abt John P, Lephart Scott M
Sports Medicine Research Institute, College of Health Sciences, University of Kentucky, 720 Sports Center Dr. Lexington, KY.
Health Services Support, United States Marine Corps Forces Special Operations Command, Camp Lejeune, NC.
Mil Med. 2018 Nov 1;183(11-12):e685-e692. doi: 10.1093/milmed/usy088.
Military personnel are at an increased risk of shoulder injuries due to training and deployment demands, however, there is a lack of information on the tactical athlete's upper extremity profile. Therefore, the purpose of this study was to examine shoulder musculoskeletal characteristics, including range of motion (ROM), strength, and function, and the relationships between these measures in Marine Corps Forces Special Operations Command (MARSOC) personnel without history of shoulder injury.
Participants included 195 full-duty male MARSOC personnel (age: 25.38 ± 2.85 yr; height: 1.79 ± 0.06 m, mass: 82.79 ± 7.88 kg) without history of shoulder injury. Measurements of ROM, strength, and function were obtained bilaterally. Shoulder internal rotation (IR) and external rotation (ER) ROM were summed to calculate total arc of motion (ARC). Shoulder IR and ER strength were assessed using an isokinetic dynamometer. Function was evaluated with an explosive push-up.
MARSOC personnel present with significantly increased ER ROM, and decreased IR ROM and ARC in their dominant shoulder. They demonstrated greater IR strength and peak force during the explosive push-up on the dominant side but no bilateral differences in average or peak rate were found. Correlation analyses suggest a weak inverse relationship between strength and ARC (r = -0.15 to -0.24). Positive relationships between strength and function were identified except for dominant IR strength and push-up variables. Those with the greatest ARC demonstrated significantly weaker IR and ER strength compared to those with less motion.
MARSOC personnel demonstrate shoulder ROM and strength symmetry patterns similar to overhead athletes. Increased dominant shoulder strength does appear to translate to a bilateral functional performance, but overall performance may be limited by the weaker nondominant upper extremity. As ARC increases, IR and ER rotation strength decrease. Repetitive, increased loading of the dominant shoulder during functional movements and training may increase risk of chronic, overuse-type injuries, common to the military. Unilateral exercises and movement analysis should be incorporated to encourage proper development of bilateral shoulder strength, which may be particularly important in those with high ranges of ARC.
由于训练和部署需求，军事人员肩部受伤的风险增加，然而，关于战术运动员上肢特征的信息却很匮乏。因此，本研究的目的是检查海军陆战队特种作战司令部（MARSOC）中无肩部损伤史人员的肩部肌肉骨骼特征，包括活动范围（ROM）、力量和功能，以及这些指标之间的关系。
参与者包括195名现役男性MARSOC人员（年龄：25.38±2.85岁；身高：1.79±0.06米，体重：82.79±7.88千克），无肩部损伤史。双侧测量ROM、力量和功能。将肩部内旋（IR）和外旋（ER）的ROM相加，计算总运动弧（ARC）。使用等速测力计评估肩部IR和ER力量。通过爆发性俯卧撑评估功能。
MARSOC人员优势肩的ER ROM显著增加，IR ROM和ARC降低。他们在优势侧爆发性俯卧撑过程中表现出更大的IR力量和峰值力，但平均速率或峰值速率未发现双侧差异。相关性分析表明力量与ARC之间存在弱负相关（r = -0.15至-0.24）。除了优势侧IR力量和俯卧撑变量外，力量与功能之间存在正相关。与运动幅度较小的人相比，ARC最大的人表现出显著较弱的IR和ER力量。
MARSOC人员表现出与过头运动运动员相似的肩部ROM和力量对称模式。优势肩力量的增加似乎确实转化为双侧功能表现，但整体表现可能受到较弱的非优势上肢的限制。随着ARC增加，IR和ER旋转力量降低。在功能性运动和训练过程中，优势肩重复性、增加的负荷可能会增加军事人员常见的慢性、过度使用型损伤的风险。应纳入单侧练习和运动分析，以促进双侧肩部力量的适当发展，这对于ARC范围较大的人可能尤为重要。
