Three‐dimensional study of the musculotendinous architecture of supraspinatus and its functional correlations

Kim, Soo Y.; Boynton, Erin; Ravichandiran, Kajeandra; Fung, Lillia; Bleakney, Robert; Agur, Anne

doi:10.1002/ca.20469

Cited by 116 publications

(153 citation statements)

References 17 publications

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“…Although growing evidence suggests that the anterior and posterior regions of supraspinatus are functionally distinct (Roh et al 2000;Kim et al 2007Kim et al , 2013Hermenegildo et al 2014), EMG activity of only the anterior portion of the muscle has been studied previously and this has been considered to be representative of the entire muscle. To the best of our knowledge, in vivo activity of the posterior region has not been assessed; thus, its contribution to modulating force postures that may elicit maximal activation of the posterior region, we assessed two types of exertions: abduction and external rotation.…”

Section: Discussionmentioning

confidence: 99%

“…Given its broader tendinous attachment, it has been theorized the posterior region likely plays an important role on the rotator cuff complex. Based on the parallel fiber bundle arrangement and fiber-type composition, the posterior region may be involved in quickly adjusting tension on the rotator cuff during dynamic movement (Kim et al 2007(Kim et al , 2013. Quick adjustments of the tendon may be particularly important in elevated arm postures and with overhead activities where any buckling of the tendon due to the muscle's shortened position could be at risk of impingement in the subacromial space.…”

Section: Methodsologymentioning

confidence: 99%

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Electromyographic investigation of anterior and posterior regions of supraspinatus: a novel approach based on anatomical insights

Kim

Dickerson

et al. 2017

International Biomechanics

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Supraspinatus is composed of anterior and posterior regions that are distinct. To date, the relative electromyographic (EMG) activity of these regions during different tasks has not been investigated. This work, thus, evaluated activity of the anterior and posterior regions of supraspinatus during isometric actions in different postures. Data were analyzed from 11 healthy participants. Fine-wire electrodes were inserted into the anterior and posterior regions of supraspinatus. EMG activity was recorded during isometric abduction and external rotation exertions against 5% of body weight resistance. Three postures for abduction (30°, 60°, and 90° of humeral abduction, scapular plane) and two for external rotation (0° and 90° humeral abduction) were tested. Each participant's data were normalized to the peak root mean square (RMS) values for the corresponding region. The RMS of the anterior region was divided by that of the posterior to calculate muscle activation ratios. Nonparametric statistics were used for analyses. The median ratio was lower during external rotation at 90° abduction compared to abduction at 30° (P = 0.003). These results suggest that the two regions of supraspinatus are functionally distinct during isometric tasks. The posterior region may play a more dominant role in postures with higher degrees of abduction and during external rotation exertions.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsologymentioning

confidence: 99%

Electromyographic investigation of anterior and posterior regions of supraspinatus: a novel approach based on anatomical insights

Kim

Dickerson

et al. 2017

International Biomechanics

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“…Techniques in the present study were developed in the laboratory and have been used previously, for example, to study lumbar multifidus, supraspinatus, and soleus (Agur et al, 2003;Kim et al, 2007;Rosatelli et al, 2008).…”

Section: Muscle and Tendon Morphologymentioning

confidence: 99%

“…FBL and PA were measured using methods previously described by Kim et al (2007). FBL was calculated as the sum of distances between the digitized points along the fiber bundle.…”

Section: Architectural Parametersmentioning

confidence: 99%

Three‐dimensional study of pectoralis major muscle and tendon architecture

Fung¹,

Wong²,

Ravichandiran³

et al. 2009

Clinical Anatomy

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A thorough understanding of the normal structural anatomy of the pectoralis major (PM) is of paramount importance in the planning of PM tendon transfers or repairs following traumatic PM tears. However, there is little consensus regarding the complex musculotendinous architecture of the PM in the anatomic or surgical literature. The purpose of this study is to model and quantify the three-dimensional architecture of the pectoralis muscle and tendon. Eleven formalin embalmed cadaveric specimens were examined: five (2M/3F) were serially dissected, digitized, and modeled in 3D using Autodesk Maya; six (4M/2F) were dissected and photographed. The PM tendon consisted of longer anterior and shorter posterior layers that were continuous inferiorly. The muscle belly consisted of an architecturally uniform clavicular head (CH) and a segmented sternal head (SH) with 6-7 segments. The most inferior SH segment in all specimens was found to fold anteriorly forming a trough that cradled the inferior aspect of the adjacent superior segment. No twisting of either the PM muscle or tendon was noted. Within the CH, the fiber bundle lengths (FBL) were found to increase from superior to inferior, whereas the mean FBLs of SH were greatest in segments 3-5 found centrally. The mean lateral pennation angle was greater in the CH (29.4 +/- 6.9 degrees ) than in the SH (20.6 +/- 2.7 degrees ). The application of these findings could form the basis of future studies to optimize surgical planning and functional recovery of repair/reconstruction procedures.

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“…Each of the two subregions could also be divided into superficial, middle, and deep parts. This division has been associated to the initiation and progression of supraspinatus tendon tears [30] . Other authors have described four functional structurally independent parts in the supraspinatus tendon.…”

Section: Tendon Structurementioning

confidence: 99%

Eccentric training as a new approach for rotator cuff tendinopathy: Review and perspectives

Camargo

Alburquerque‐Sendín

Salvini

2014

WJO

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Excessive mechanical loading is considered the major cause of rotator cuff tendinopathy. Although tendon problems are very common, they are not always easy to treat. Eccentric training has been proposed as an effective conservative treatment for the Achilles and patellar tendinopathies, but less evidence exists about its effectiveness for the rotator cuff tendinopathy. The mechanotransduction process associated with an adequate dose of mechanical load might explain the beneficial results of applying the eccentric training to the tendons. An adequate load increases healing and an inadequate (over or underuse) load can deteriorate the tendon structure. Different eccentric training protocols have been used in the few studies conducted for people with rotator cuff tendinopathy. Further, the effects of the eccentric training for rotator cuff tendinopathy were only evaluated on pain, function and strength. Future studies should assess the effects of the eccentric training also on shoulder kinematics and muscle activity. Individualization of the exercise prescription, comprehension and motivation of the patients, and the establishment of specific goals, practice and efforts should all be considered when prescribing the eccentric training.In conclusion, eccentric training should be used aiming improvement of the tendon degeneration, but more evidence is necessary to establish the adequate doseresponse and to determine long-term follow-up effects. Key words: Cellular; Mechanotransduction; Rehabilitation; Shoulder Impingement; Supraspinatus; Tendon injuries Core tip: Eccentric training can be considered a new and ambitious treatment approach for several tendinopathies. The paper establishes the basic principles for explaining the effects on the tendon of an intense mechanical load, as the eccentric training. Further, the authors bring other possible explanations of the success of this training for tendinopathies, as the individualization of the exercise programs and the motivation of the patients who reach specific goals. Negative and side effects are also identified. Finally, the main evidence afforded by original articles is commented and future research purposes are defined.Camargo PR, Alburquerque-Sendín F, Salvini TF. Eccentric training as a new approach for rotator cuff tendinopathy: Review and perspectives. World J Orthop 2014; 5(5): 634-644 Available from:

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Three‐dimensional study of the musculotendinous architecture of supraspinatus and its functional correlations

Cited by 116 publications

References 17 publications

Electromyographic investigation of anterior and posterior regions of supraspinatus: a novel approach based on anatomical insights

Electromyographic investigation of anterior and posterior regions of supraspinatus: a novel approach based on anatomical insights

Three‐dimensional study of pectoralis major muscle and tendon architecture

Eccentric training as a new approach for rotator cuff tendinopathy: Review and perspectives

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