Rotator cuff and posterior-superior glenoid labrum injury associated with increased glenohumeral motion: A new site of impingement

Davidson, Philip A.; ElAttrache, Neal S.; Jobe, Christopher M.; Jobe, Frank W.

doi:10.1016/s1058-2746(95)80023-9

Cited by 200 publications

(117 citation statements)

References 11 publications

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“…The insufflations of the joint may have made the rotator cuff contact the superior glenoid at a higher angle than would occur physiologically when there is little fluid in the joint. However, a fluid pump has been used at the time of arthroscopy by others evaluating contact of the rotator cuff with the superior glenoid [7,15,17,18,24,35,37]. Second, it is possible making the measurements with the patients standing when awake and in the lateral position under anesthesia could have affected the results.…”

Section: Discussionmentioning

confidence: 99%

“…Cuff-glenoid contact has been observed with the arm in abduction and external rotation (called ''internal impingement'') and with the arm in forward flexion (called ''flexion contact'') [7,18,38]. Cuff-glenoid contact with the arm in abduction and external rotation or with the arm in flexion has been documented in cadaver [36], MRI [16], and clinical studies involving arthroscopy [18,30,35].…”

Section: Introductionmentioning

confidence: 99%

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Does a Positive Neer Impingement Sign Reflect Rotator Cuff Contact with the Acromion?

Jia

Pannirselvam

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background One possible cause of shoulder pain is rotator cuff contact with the superior glenoid (cuff-glenoid contact) with the arm in flexion, as occurs during a Neer impingement sign. It has been assumed that the pain with a Neer impingement sign on physical examination of the shoulder was secondary to the rotator cuff making contact with the anterior and lateral acromion. Questions/purposes We determined if the arm position where pain occurs with a Neer impingement sign would correlate with the position where the rotator cuff made contact with the superior glenoid, as determined by arthroscopic evaluation. Patients and Methods We prospectively studied 398 consecutive patients with a positive Neer impingement sign during office examination and used a handheld goniometer to measure (in degrees of flexion) the arm position in which impingement pain occurred. During subsequent arthroscopy, the arm was moved into a similar position, and we measured the arm's position in flexion at the point the rotator cuff made contact with the superior glenoid using a handheld goniometer. We compared the degrees of flexion at which pain occurred preoperatively and at which there was cuff-glenoid contact.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does a Positive Neer Impingement Sign Reflect Rotator Cuff Contact with the Acromion?

Jia

Pannirselvam

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…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%

“…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. 3,15,22,34 Some have suggested that scapular dysfunction may play a significant role in pathologic internal impingement. 2,12 To date, there is no research to identify if scapular dysfunction is present in throwers diagnosed with pathologic internal impingement.…”

Section: P Revious Research Hasmentioning

confidence: 99%

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Scapular Dysfunction in Throwers with Pathologic Internal Impingement

Laudner

Myers

Pasquale

et al. 2006

J Orthop Sports Phys Ther

192

153

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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.

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Softball

Baker¹

2000

Women in Sport

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Rotator cuff and posterior-superior glenoid labrum injury associated with increased glenohumeral motion: A new site of impingement

Cited by 200 publications

References 11 publications

Does a Positive Neer Impingement Sign Reflect Rotator Cuff Contact with the Acromion?

Does a Positive Neer Impingement Sign Reflect Rotator Cuff Contact with the Acromion?

Scapular Dysfunction in Throwers with Pathologic Internal Impingement

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