ArticlesManual scapular stabilization: Its effect on shoulder rotational range of motion☆,☆☆,★
Section snippets
Subjects
Three hundred twenty-five high school athletes attending the annual preparticipation examinations were given the opportunity to participate in the study. Of these, 50 athletes (age 12 to 18yrs) volunteered, including 18 boys and 32 girls. Inclusion criteria included willingness to participate in day 2 of the study; no previous history of neurologic disease, arthritis, connective tissue disease, or shoulder/neck injury or surgery; and parental informed consent. Demographic data were collected,
Results
The mean values for goniometrically measured shoulder internal, external, and total rotations (table 2) showed that scapular stabilization significantly affected shoulder rotation: rotation measurements with the scapula stabilized were significantly smaller (p <.001) than rotation measurements with no stabilization for all 3 end points.Differences in ROM with respect to arm dominance and gender were detected, independent of scapular stabilization (table 2). The dominant arm had a larger
Discussion
The present study has attempted to demonstrate the reliability of a recently described technique of manually stabilizing the scapula in order to isolate glenohumeral RROM more reliably. Loss of glenohumeral internal rotation may be a pathologic finding in an overhead athlete, predisposing to impingement, overuse injuries, and impaired performance.4, 5, 6, 7, 8 It is now becoming accepted practice in the rehabilitation as well as preventative conditioning of overhead athletes to incorporate a
Conclusion
A recently described technique for measuring shoulder RROM in which the scapula is manually stabilized was studied and found to be more reliable and reproducible than a currently used technique, particularly for measurement of internal rotation. External rotation was less affected by manual stabilization than internal rotation, presumably because of biomechanical factors. Manual scapular stabilization, with the arm abducted to 90°, is recommended when measuring internal rotation.
Acknowledgements
The authors thank Dirk Larson, MS, and Terry M. Therneau, PhD, of the Department of Biostatistics, Mayo Clinic, for their statistical contribution to this study, and Dave Kraus, PT, Pete Lommen, PT, Tim McLean, PT, and Jeff Brault, DO, PT, from the Mayo Clinic Sports Medicine Center, for their technical assistance.
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Reprint requests to Jay Smith, MD, Department of Physical Medicine and Rehabilitation, Mayo Clinic, 200 First St SW, Rochester, MN 55905.
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