Suzuki Yusuke, Muraki Takayuki, Sekiguchi Yusuke, Ishikawa Hiroaki, Yaguchi Haruki, Suzuki Yutaro, Morise Shuhe, Honda Keita, Izumi Shin-Ichi
Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan; Department of Rehabilitation, Matsuda Hospital, 17-1 Tachitayasiki, Sanesawa, Izumi-ku, sendai, 981-3217, Japan.
Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan.
Gait Posture. 2019 Jan;67:207-212. doi: 10.1016/j.gaitpost.2018.10.022. Epub 2018 Oct 19.
Throwing injuries to the shoulder joint often occur during shoulder external rotation. An appropriate combination of thoracic, scapular, and humeral motion during throwing is important to prevent such injuries, but it is unclear how thoracic posture contributes to shoulder motion during throwing.
The purpose of this study, therefore, was to clarify the influence of thoracic posture on scapulothoracic and glenohumeral motion during shoulder external rotation.
Eccentric external rotation at 90° of shoulder abduction in thoracic flexion and extension postures was performed by 15 asymptomatic participants. Three-dimensional scapulothoracic and glenohumeral movements were measured with an electromagnetic tracking device at 75°, 80°, 85°, and maximum shoulder external rotation. The thoracic angle and maximum shoulder external rotation in absolute coordination were measured with a three-dimensional motion capture system.
The results showed that scapular posterior tilting and external rotation in the thoracic extension posture were significantly greater than those in the flexion posture (p < 0.05). Glenohumeral horizontal extension was significantly less in the thoracic extension posture than in the flexion posture (p < 0.05), whereas maximum shoulder external rotation was significantly greater (p < 0.01). Thus, thoracic extension increased scapulothoracic posterior tilting and external rotation and reduced glenohumeral horizontal extension during shoulder external rotation, as well as increasing maximum shoulder external rotation.
These findings suggest that thoracic extension may contribute to reduction of mechanical demand in the glenohumeral joint during throwing, potentially reducing shoulder injuries.
肩关节的投掷损伤常发生在肩部外旋过程中。投掷时胸廓、肩胛骨和肱骨运动的适当组合对于预防此类损伤很重要,但尚不清楚胸廓姿势在投掷过程中如何影响肩部运动。
因此,本研究的目的是阐明胸廓姿势对肩部外旋过程中肩胛胸壁关节和盂肱关节运动的影响。
15名无症状参与者在胸廓屈曲和伸展姿势下进行肩关节外展90°时的离心外旋。使用电磁跟踪设备在75°、80°、85°和最大肩部外旋时测量三维肩胛胸壁关节和盂肱关节运动。使用三维运动捕捉系统测量绝对坐标系下的胸廓角度和最大肩部外旋。
结果表明,胸廓伸展姿势下肩胛骨后倾和外旋明显大于屈曲姿势(p < 0.05)。胸廓伸展姿势下盂肱关节水平伸展明显小于屈曲姿势(p < 0.05),而最大肩部外旋明显更大(p < 0.01)。因此,胸廓伸展在肩部外旋过程中增加了肩胛胸壁关节后倾和外旋,减少了盂肱关节水平伸展,同时增加了最大肩部外旋。
这些发现表明,胸廓伸展可能有助于减少投掷过程中盂肱关节的机械需求,从而可能减少肩部损伤。