Cavanaugh Emma, Arcot Santillan Atenas, Hoshikawa Kyosuke, Giambini Hugo
Department of Biomedical Engineering and Chemical Engineering, The University of Texas at San Antonio, San Antonio, TX 78249, USA.
Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, Yamagata 990-2212, Japan.
Sports (Basel). 2024 Dec 18;12(12):349. doi: 10.3390/sports12120349.
Shoulder and elbow injuries are prevalent among baseball players, particularly pitchers, who experience repetitive eccentric loading of the shoulder, leading to muscle damage and increased injury risk. Nearly 40% of shoulder injuries in baseball occur in pitchers, with many facing low rates of return to sport. The rotator cuff (RC) muscles-supraspinatus (SSP), infraspinatus (ISP), subscapularis (SSC), and teres minor (TMin)-are crucial for shoulder stability, movement, and force generation, particularly in overhead sports. Each RC muscle comprises subregions with distinct biomechanical properties, such as strength, moment arm behavior, and activation patterns. These differences allow for a finely tuned balance between joint stability and mobility. For example, the superior subregion of the ISP significantly contributes to external rotation, a function critical in sports like baseball that require precision and power. During pitching, the SSP, ISP, and SSC stabilize the glenohumeral joint through high activation during explosive phases, such as stride, arm cocking, and arm acceleration. Understanding these functional subregional differences is vital for diagnosing and managing shoulder pathologies like RC tears. Despite advancements, clinicians face challenges in predicting re-injury risks and determining return-to-play readiness for athletes with shoulder injuries. Integrating insights into subregional biomechanics with patient care could enhance outcomes. Tailored interventions-whether surgical or rehabilitative-targeting specific subregions could improve recovery times, reduce re-injury risks, and enable more personalized treatment plans. Such approaches are especially beneficial for athletes, older individuals, and those prone to RC injuries, promoting better long-term shoulder health and performance. The present work aims to highlight some of the research on these subregions and their differences, providing insights to enhance treatment approaches for shoulder injuries.
肩部和肘部损伤在棒球运动员中很常见，尤其是投手，他们的肩部会经历反复的离心负荷，导致肌肉损伤并增加受伤风险。棒球运动中近40%的肩部损伤发生在投手中，许多人恢复运动的几率较低。肩袖（RC）肌肉——冈上肌（SSP）、冈下肌（ISP）、肩胛下肌（SSC）和小圆肌（TMin）——对于肩部稳定性、运动和力量产生至关重要，特别是在过头运动中。每条RC肌肉都由具有不同生物力学特性的子区域组成，如力量、力臂行为和激活模式。这些差异使得关节稳定性和灵活性之间能够实现精确的平衡。例如，ISP的上子区域对外部旋转有显著贡献，这一功能在棒球等需要精准度和力量的运动中至关重要。在投球过程中，SSP、ISP和SSC在爆发阶段（如跨步、手臂后摆和手臂加速）通过高激活来稳定盂肱关节。了解这些功能性子区域差异对于诊断和管理如肩袖撕裂等肩部疾病至关重要。尽管取得了进展，但临床医生在预测再次受伤风险和确定肩部受伤运动员的恢复比赛准备情况方面仍面临挑战。将子区域生物力学的见解与患者护理相结合可以改善治疗结果。针对特定子区域的定制干预措施——无论是手术还是康复——可以缩短恢复时间，降低再次受伤风险，并制定更个性化的治疗计划。这些方法对运动员、老年人和那些容易发生肩袖损伤的人特别有益，有助于促进更好的长期肩部健康和表现。本研究旨在突出一些关于这些子区域及其差异的研究，为改进肩部损伤的治疗方法提供见解。
