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Biomechanical insights into the aetiology of infraspinatus syndrome
  1. Jonathan C Reeser1,
  2. Glenn S Fleisig2,
  3. Ann M J Cools3,
  4. Darcie Yount2,
  5. Scott A Magnes4
  1. 1Marshfield Clinic Research Foundation, Marshfield, Wisconsin, USA
  2. 2American Sports Medicine Institute, Birmingham, Alabama, USA
  3. 3Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Gent, Belgium
  4. 4Department of Orthopaedic Surgery, Captain James A, Lovell Federal Health Care Center, North Chicago, Illinois, USA
  1. Correspondence to Jonathan C Reeser, Marshfield Clinic Research Foundation, 1000 N Oak Avenue, Marshfield, Wisconsin 54449, USA; reeser.jonathan{at}


Objective Infraspinatus syndrome (IS) results from injury to the suprascapular nerve. For reasons that are poorly understood, volleyball players are at greater risk of developing IS than are athletes who compete in other overhead sports. Differences between the shoulder kinematics of volleyball-related overhead skills and those skills demanded by other overhead sports might explain the pronounced prevalence of IS among volleyball athletes.

Design Observational, laboratory-based, cross-sectional study.

Setting The American Sports Medicine Institute.

Participants Fourteen healthy female Division 1 collegiate volleyball athletes.

Methods Upper limb biomechanics of 14 healthy female Division 1 collegiate volleyball athletes while spiking and serving were quantified, then compared to the results from data previously obtained from female baseball pitchers and tennis players.

Results Although the general movement pattern at the shoulder girdle is qualitatively similar for the upper limb skills required by a variety of overhead sports, volleyball spiking and serving result in greater shoulder abduction and horizontal adduction at the moment of ball contact/release than do baseball pitching or tennis serving.

Conclusion The authors suggest that the unique scapular mechanics which permit the extreme shoulder abduction and horizontal adduction that characterise volleyball spiking and serving place anatomically predisposed volleyball athletes at increased risk for developing cumulative traction-related injury to the suprascapular nerve at the level of the spinoglenoid notch.

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  • Competing interests None.

  • Ethics approval Marshfield Clinic Research Foundation Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • ▸ References to this paper are available online at