Reed Maddox L, Begalle Rebecca L, Laudner Kevin G
School of Kinesiology and Recreation, Illinois State University, Normal, IL, USA.
Int J Sports Phys Ther. 2018 Dec;13(6):1024-1031.
Posterior shoulder tightness (PST), defined as limited glenohumeral (GH) horizontal adduction and internal rotation motion, is a common occurrence in overhead athletes, particularly baseball and softball players, as a result of the extreme forces on the GH joint and the high number of throwing repetitions. Despite clinical evidence suggesting the use of joint mobilizations and muscle energy techniques (MET) for treating PST, there currently are no data examining the overall effectiveness of joint mobilizations and MET to determine optimal treatment for posterior shoulder tightness.
To compare the acute effectiveness of MET and joint mobilizations for reducing posterior shoulder tightness, as measured by passive GH horizontal adduction and internal rotation ROM, among high school baseball and softball players.
Randomized controlled study.
Forty-two asymptomatic high school baseball and softball players were randomly assigned to one of three groups (14 MET, 14 joint mobilization, 14 control). Glenohumeral passive adduction and internal rotation ROM were measured in all participants in a pre-test post-test fashion. Between testing, the joint mobilization group received one application of GH posterior joint mobilizations. The MET group received one cycle of MET applied to the GH horizontal abductors. The control group received no intervention. Posttests measures were completed immediately following intervention or a similar amount of time resting for the control group and then again 15 minutes later.
One-way analyses of covariance showed that the MET group had significantly more horizontal adduction ROM post-treatment compared to the control group ( = 0.04). No significant differences existed between groups in horizontal adduction ( > 0.16) or internal rotation (>.28) or at the 15-minute posttests ( > 0.70).
The results of this study indicate the application of MET to the horizontal abductors provides acute improvements to GH horizontal adduction ROM in high school baseball and softball players, while joint mobilizations provide no improvements.
后肩部紧张（PST）被定义为盂肱（GH）关节水平内收和内旋运动受限，在过头运动的运动员中很常见，尤其是棒球和垒球运动员，这是由于GH关节受到的极端力量和大量的投掷重复动作所致。尽管有临床证据表明使用关节松动术和肌肉能量技术（MET）来治疗PST，但目前尚无数据研究关节松动术和MET的整体有效性，以确定后肩部紧张的最佳治疗方法。
比较高中棒球和垒球运动员中，通过被动GH关节水平内收和内旋活动度（ROM）测量，MET和关节松动术在减轻后肩部紧张方面的急性效果。
随机对照研究。
42名无症状的高中棒球和垒球运动员被随机分配到三组之一（14名接受MET组，14名接受关节松动术组，14名对照组）。所有参与者均采用测试前-测试后的方式测量GH关节被动内收和内旋ROM。在测试期间，关节松动术组接受一次GH关节后关节松动术。MET组接受一轮应用于GH水平外展肌的MET。对照组不接受干预。干预后或对照组休息相同时间后立即进行后测，然后在15分钟后再次进行后测。
单因素协方差分析显示，与对照组相比，MET组治疗后水平内收ROM显著增加（P = 0.04）。在水平内收（P > 0.16）、内旋（P > 0.28）或15分钟后测时（P > 0.70），各组之间无显著差异。
本研究结果表明，对高中棒球和垒球运动员的水平外展肌应用MET可使GH关节水平内收ROM得到急性改善，而关节松动术则无改善。
1级。
