Abdollahi Sajjad, Sheikhhoseini Rahman, Salsali Mohammad, Piri Hashem, Hides Julie A
Department of Sport Biomechanics, Faculty of Sports Sciences, Bu-Ali Sina University, Hamedan, Iran.
Department of Corrective Exercise & Sport Injury, Faculty of Physical Education and Sport Sciences, Allameh Tabataba'i University, Western Azadi Sport Complex Boulevard, Hakim Highway, Tehran, Iran.
J Orthop Surg Res. 2025 Aug 20;20(1):776. doi: 10.1186/s13018-025-06212-1.
Scapulothoracic motion during arm elevation involves scapular posterior tilt (PT), upward rotation (UR), and external rotation (ER). Abnormal scapular kinematics are common in people with chronic shoulder pain, potentially exacerbating symptoms and impairing function. Push-ups, a common exercise for shoulder rehabilitation, may influence scapular motion but have not been extensively studied in this context. Thus, this study aimed to investigate the effect of hand position on scapular kinematics during a push-up exercise in athletes with and without chronic shoulder pain (CSP).
Twenty-four male overhead athletes were allocated into two groups: CSP ( = 12) and Control (CON; = 12). Scapular kinematics in three planes (PT, UR, and ER) were measured using a Vicon motion capture system during push-ups in three hand positions (internal rotation, IR; neutral rotation, NR; and external rotation, ER). Measurements were taken in the concentric phase of the push-up. Statistical analyses using repeated-measures ANOVA assessed the effects of hand position and elbow extension on scapular kinematics between the two groups.
For PT of the scapula, in the IR hand position, participants from both the CON and CSP groups showed similar decreases (CON group = from 25.74° to -16.10°; < 0.001). In the NR hand condition, the CON group decreased PT from 16.12° to -15.98° ( < 0.001), but there was no significant change in the CSP group. In the ER hand condition, for the CON group, PT decreased from 18.63° to -9.38° ( < 0.026), with no significant change observed in the CSP group. For UR of the scapula, the CON group showed significant decreases in the IR hand condition (from 15.37° to -2.28°; < 0.019), while the CSP showed minimal changes. In the IR hand condition, the ER of the scapula increased from 20.44° to 25.13° ( < 0.003) in the CON group. At the same time, the CSP showed smaller changes. In the NR hand condition, ER of the scapula in the CON group decreased from 24.79° to 9.38° ( < 0.001), with no significant change observed in the CSP group.
Scapular kinematics (UR, PT, and ER) differed significantly across hand rotation conditions and groups. The CON group exhibited more pronounced changes in these kinematic measures, while the CSP group showed limited variation. This may indicate an association between chronic pain and movement restriction. These findings emphasize the need for targeted rehabilitation strategies that consider these kinematic differences.
The online version contains supplementary material available at 10.1186/s13018-025-06212-1.
手臂抬高过程中的肩胸运动包括肩胛骨后倾（PT）、向上旋转（UR）和外旋（ER）。异常的肩胛骨运动学在慢性肩痛患者中很常见，可能会加重症状并损害功能。俯卧撑是肩部康复的常见运动，可能会影响肩胛骨运动，但在这方面尚未得到广泛研究。因此，本研究旨在调查手位对有或无慢性肩痛（CSP）的运动员在俯卧撑运动中肩胛骨运动学的影响。
24名男性上肢运动员被分为两组：CSP组（n = 12）和对照组（CON；n = 12）。在三种手位（内旋，IR；中立旋转，NR；和外旋，ER）的俯卧撑过程中，使用Vicon运动捕捉系统测量肩胛骨在三个平面（PT、UR和ER）的运动学。测量在俯卧撑的向心阶段进行。使用重复测量方差分析进行统计分析，评估手位和肘部伸展对两组之间肩胛骨运动学的影响。
对于肩胛骨的PT，在IR手位，CON组和CSP组的参与者均表现出类似程度的下降（CON组=从25.74°降至-16.10°；P < 0.001）。在NR手位条件下，CON组的PT从16.12°降至-15.98°（P < 0.001），而CSP组无显著变化。在ER手位条件下，对于CON组，PT从18.63°降至-9.38°（P < 0.026），CSP组未观察到显著变化。对于肩胛骨的UR，CON组在IR手位条件下显著下降（从15.37°降至-2.28°；P < 0.019），而CSP组变化极小。在IR手位条件下，CON组肩胛骨的ER从20.44°增加到25.13°（P < 0.003）。同时，CSP组变化较小。在NR手位条件下，CON组肩胛骨的ER从24.79°降至9.38°（P < 0.001），CSP组未观察到显著变化。
肩胛骨运动学（UR、PT和ER）在不同的手旋转条件和组间存在显著差异。CON组在这些运动学指标上表现出更明显的变化，而CSP组变化有限。这可能表明慢性疼痛与运动受限之间存在关联。这些发现强调了需要考虑这些运动学差异的针对性康复策略。
在线版本包含可在10.1186/s13018-025-06212-1获取的补充材料。
