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大学生棒球投手的肩后僵硬与投掷时的肩部疼痛有关:剪切波弹性成像评估。

Posterior shoulder stiffness was associated with shoulder pain during throwing in college baseball players: assessment of shear wave elastography.

机构信息

Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.

Graduate School of Health and Sports Science, Juntendo University, Inzai, Japan.

出版信息

Eur J Orthop Surg Traumatol. 2023 May;33(4):1237-1244. doi: 10.1007/s00590-022-03286-z. Epub 2022 May 18.

Abstract

PURPOSE

To investigate shoulder stiffness on the throwing and non-throwing sides in college baseball players using ultrasound shear wave elastography (SWE), and investigate the relationship between stiffness and shoulder pain during throwing.

METHODS

Forty-nine college baseball players (98 shoulders) were recruited. Shoulder range of motion was evaluated. SWE was used to measure stiffness of the bilateral supraspinatus tendons, infraspinatus tendons, subscapularis tendons, supraspinatus muscles, infraspinatus muscles (ISPM), and posterior capsules. Participants were divided into pain and no pain groups based on the presence or absence of shoulder pain during throwing within 1 month before measurements on the throwing side. Items were compared between the throwing and non-throwing sides, and between the pain and no pain groups. Factors affecting shoulder pain during throwing were also investigated via multiple logistic regression analysis.

RESULTS

Compared with the non-throwing side, the throwing side had significantly greater external rotation at 90° abduction, significantly lesser internal rotation at 0° abduction and internal rotation at 90° abduction (AbdIR), significantly higher SWE values of the infraspinatus tendon, ISPM, and posterior capsule, and significantly lower SWE values of the subscapularis tendon. Compared with the no pain group, the pain group had a significantly higher SWE value of the ISPM, and significantly lesser AbdIR. Increased ISPM SWE values and decreased AbdIR were significantly correlated with shoulder pain during throwing.

CONCLUSIONS

The posterior tissue was stiffer than the anterior tissue on the throwing side. Decreased AbdIR and increased ISPM stiffness may be correlated with shoulder pain during throwing.

摘要

目的

使用超声剪切波弹性成像(SWE)研究大学生棒球运动员投掷肩和非投掷肩的肩部僵硬,并研究僵硬与投掷时肩部疼痛的关系。

方法

招募了 49 名大学生棒球运动员(98 个肩膀)。评估肩部活动度。使用 SWE 测量双侧冈上肌腱、冈下肌腱、肩胛下肌腱、冈上肌、冈下肌(ISPM)和后囊的僵硬程度。根据投掷侧测量前 1 个月内是否存在投掷时肩部疼痛,将参与者分为疼痛组和无疼痛组。比较投掷侧和非投掷侧、疼痛组和无疼痛组之间的差异。还通过多因素逻辑回归分析研究了影响投掷时肩部疼痛的因素。

结果

与非投掷侧相比,投掷侧在 90°外展时有更大的外旋度,在 0°外展和 90°外展时有更小的内旋度(AbdIR),冈下肌腱、ISPM 和后囊的 SWE 值更高,而肩胛下肌腱的 SWE 值更低。与无疼痛组相比,疼痛组的 ISPM 的 SWE 值更高,AbdIR 值更小。ISPM 的 SWE 值增加和 AbdIR 值减少与投掷时肩部疼痛显著相关。

结论

在投掷侧,后组织比前组织更僵硬。AbdIR 减少和 ISPM 僵硬度增加可能与投掷时肩部疼痛有关。

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