Internal Impingement of the Shoulder: Comparison of Findings Between the Throwing and Nonthrowing Shoulders of College Baseball Players

Halbrecht, Jeffrey; Tirman, P. F. J.; Atkin, David

doi:10.1016/s0749-8063(99)70030-7

Cited by 176 publications

(108 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We agree some subtle form of anterior instability may cause similar symptoms, but the athletes of our series did not show clinical or imaging signs or arthroscopic lesions of anterior instability. Indeed, Halbrecht et al [7] found internal posterior impingement decreased with anterior instability. Burkhart et al [5] considered the retraction of the posteroinferior capsule frequently observed in these athletes as the primary cause.…”

Section: Discussionmentioning

confidence: 99%

Surgical Technique Arthroscopic Posterior Glenoidplasty for Posterosuperior Glenoid Impingement in Throwing Athletes

Lévigne¹,

Garret²,

Grosclaude³

et al. 2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Posterosuperior glenoid impingement (PSGI) is the repetitive impaction of the supraspinatus tendon insertion on the posterosuperior glenoid rim in abduction and external rotation. While we presume the pain is mainly caused by mechanical impingement, this explanation is controversial. If nonoperative treatment fails, arthroscopic débridement of tendinous and labral lesions has been proposed but reportedly does not allow a high rate of return to sports. In 1996, we proposed adding abrasion of the bony posterior rim, or glenoidplasty.

show abstract

Section: Discussionmentioning

confidence: 99%

Surgical Technique Arthroscopic Posterior Glenoidplasty for Posterosuperior Glenoid Impingement in Throwing Athletes

Lévigne¹,

Garret²,

Grosclaude³

et al. 2012

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…3,7,9,15,22,28,34 However, very little data are currently available that empirically describe scapular alterations among these athletes. The results of this study indicate that throwers diagnosed with pathological internal impingement demonstrate statistically significant increases in SC elevation and scapular posterior tilt position compared to throwers without internal impingement.…”

Section: Discussionmentioning

confidence: 99%

“…While it is believed that contact between the humeral head and the posterior-superior glenoid labrum is a normal physiological occurrence, the biomechanics of the throwing motion are believed to intensify this contact and its effect on the involved anatomical structures. 3,5,7,9,15,22,28,34 Thus, pathological internal impingement of the supraspinatus and infraspinatus can result. Using arthroscopy, clinicians have identified undersurface lesions on the posterior aspect of the supraspinatus and anterior portion of the infraspinatus tendons, and fraying of the posteriorsuperior glenoid labrum in overhead athletes.…”

Section: P Revious Research Hasmentioning

confidence: 99%

Scapular Dysfunction in Throwers with Pathologic Internal Impingement

Laudner

Myers

Pasquale

et al. 2006

J Orthop Sports Phys Ther

192

153

View full text Add to dashboard Cite

Study Design: Case control group study. Objectives: To compare scapular position and orientation between baseball players with and without pathologic internal impingement. Background: Scapular dysfunction has been implicated as a contributor to throwing-related pathologic internal impingement of the shoulder due to its role in increasing the contact between the greater tuberosity and posterior-superior glenoid, thereby impinging the posterior rotator cuff tendon(s) and labrum. However, to date, no definitive data demonstrate this scapular dysfunction in throwing athletes. The purpose of this study was to assess, in a controlled laboratory environment, whether scapular position and orientation would be different in throwing athletes diagnosed with pathologic internal impingement than in a control group of throwing athletes. Methods and Measures: Eleven throwing athletes diagnosed with pathologic internal impingement, using both clinical examination and a magnetic resonance arthrogram, were demographically matched with a control group of 11 throwers with no history of upper extremity injury. An electromagnetic tracking device was used to measure scapular internal/external rotation, anterior/ posterior tilt, upward/downward rotation, sternoclavicular protraction/retraction, and elevation/ depression during humeral elevation within the scapular plane. Comparisons were made between groups with analysis of variance models (PϽ.05). Results:The individuals in the pathologic internal impingement group demonstrated statistically significant increased sternoclavicular elevation when elevating their humerus from 30°to 120°( P = .002) and from 60°to 120°(P = .003), compared to the control group. Furthermore, these patients also had increased posterior scapular tilt position (P = .016). No statistically significant differences were present in any other scapular variables measured. Conclusions: Based on the results of this study, throwing athletes diagnosed with pathologic internal impingement present with statistically significant increases in sternoclavicular elevation and scapular posterior tilt position during humeral elevation in the scapular plane.

show abstract

“…Many lesions are reportedly associated with throwing injuries, including articular sided tears of the supraspinatus or infraspinatus muscle, labral lesions, Bennett lesions, humeral head lesions or cysts, and glenoid bony lesions [11][12][13][14][15][16][17][18][19]. However, most disabled throwing shoulders improve without surgical intervention, and the findings of such lesions are not always related to the patient's symptoms [15,20,21], suggesting other causes of the shoulder disability.…”

Section: Discussionmentioning

confidence: 99%

Involvement of the Subscapular Bursa as a Cause of Throwing Pain

Inui¹

2015

JESO

View full text Add to dashboard Cite

Open Access Research Articlethe bursae play an important role in the suppression of friction associated with those movements. We hypothesized that friction of the subscapularis tendon coiling along the coracoid process often causes pain during throwing motion and investigated in which position pain would occur in a clinical scenario. MethodsThis study involved 110 baseball players who visited our hospital for consultation regarding their symptoms and who were followed up for at least 6 months. All were men with an average age of 27 years (range, 16-36 years). The dominant arm was affected in all players. The subjects comprised 52 high schooling, 11 collegiate, 9 professional, and 38 recreational level players. Their baseball playing positions were 50 pitchers, 9 catchers, 19 infielders, and 32 outfielders. Clinical featuresAll players complained of shoulder pain during throwing, especially in the acceleration phase, and stated that their performance level was decreased owing to throwing pain. The passive glenohumeral range of motion was assessed using a large goniometer. Angles of internal and external rotations in the coronal plane at 90° of abduction were measured in bilateral sides. Measurements were recorded with each subject lying supine to stabilize the scapula. The dominant extremity showed more external rotation at 90° of abduction and less internal rotation at 90° of abduction than did the contralateral extremity. The mean external rotation and internal rotation with the dominant extremity were 105° ± 13° and 50° ± 12°, respectively, and those with the contralateral extremity were 101° ± 14° and 59° ± 11°, respectively. Distension arthrographyTen milliliters of dye compounded with 10 ml of local anesthetic was injected into the joint. In 29 patients (26%), leakage or pooling of the dye in the supraspinatus or infraspinatus tendons occurred (Figure 1). After evaluation, the shoulder was forced to internally rotate to distend the dye to the subscapularis bursa. This direction of dye distension was confirmed with plain radiographs after arthrography (Figure 2). In 14 patients, the dye also leaked from the bicipital groove. AbstractLittle attention has been paid to a role of the subscapular bursa keeping smooth movement of the shoulder. We hypothesized that irritation in the subscapular bursa causes throwing pain and investigated in which position pain would occur in a clinical scenario and effectiveness of distension arthrography for pain relief in baseball players. One hundred and ten baseball players with shoulder pain were enrolled in this study. All underwent examination of whether pain was provoked with arm rotation at different angles of abduction before and after arthrography. Factors including skill level, playing position, symptom duration, and concurrent injury of the rotator cuff tendon were investigated to affect the results. All patients experienced pain with external rotation at 135° of abduction before arthrography, and the pain was reduced after arthrography in 92 players (84%). Thirty-thre...

show abstract

Internal Impingement of the Shoulder: Comparison of Findings Between the Throwing and Nonthrowing Shoulders of College Baseball Players

Cited by 176 publications

References 17 publications

Surgical Technique Arthroscopic Posterior Glenoidplasty for Posterosuperior Glenoid Impingement in Throwing Athletes

Surgical Technique Arthroscopic Posterior Glenoidplasty for Posterosuperior Glenoid Impingement in Throwing Athletes

Scapular Dysfunction in Throwers with Pathologic Internal Impingement

Involvement of the Subscapular Bursa as a Cause of Throwing Pain

Contact Info

Product

Resources

About