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Schwartz C, Tooth C, Gofflot A, Martens G, Croisier JL, Denoël V, Brüls O, Forthomme B. Strength and activity of the protractor and retractor muscles of the asymptomatic dyskinetic scapula. J Electromyogr Kinesiol 2024; 77:102899. [PMID: 38810415 DOI: 10.1016/j.jelekin.2024.102899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/24/2024] [Accepted: 05/23/2024] [Indexed: 05/31/2024] Open
Abstract
The role of scapular dyskinesis as a risk factor of shoulder injury has been largely discussed. However, most studies have focused on symptomatic patients and less is known on the asymptomatic dyskinetic scapula. Removing the confounding effects of the pathologies could contribute to better characterize the scapula dyskinesis. As muscle properties (strength, fatigue, nerve injury …) have been identified as causative factors of scapular dyskinesis, this study focuses specifically on characterizing the protractor and retractor muscles of the dyskinetic scapula. Thirteen asymptomatic dyskinetic volunteers were compared to eleven asymptomatic non-dyskinetic control volunteers. Muscle characteristics were evaluated in terms of maximal strength, fatigue resistance and electromyographic activity during a functional closed-chained task. The results did not identify kinematic or muscle activity significant differences between the dyskinetic and the control group even in fatigue conditions. However, the results demonstrated that protractors vs. retractors fatigue resistance ratios were imbalanced (<0.8) in the dyskinetic group and significantly lower than in the non-dyskinetic one. Our study suggests that that strength imbalances are not necessarily related to the presence of pain at the shoulder joint. These results demonstrated the importance to complete the clinical assessments of the scapula with strength evaluations even for asymptomatic sport practitioners.
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Affiliation(s)
- Cédric Schwartz
- LAM - Motion Lab, University of Liège, Belgium; Department of Physical Activity and Rehabilitation Sciences, University of Liège, Liège, Belgium; Department of Urban and Environmental Engineering, University of Liège, Liège, Belgium; Department of Aerospace and Mechanical Engineering, University of Liège, Liège, Belgium.
| | - Camille Tooth
- LAM - Motion Lab, University of Liège, Belgium; Department of Physical Activity and Rehabilitation Sciences, University of Liège, Liège, Belgium; ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, University Hospital of Liège, Belgium
| | - Amandine Gofflot
- LAM - Motion Lab, University of Liège, Belgium; Department of Physical Activity and Rehabilitation Sciences, University of Liège, Liège, Belgium
| | - Géraldine Martens
- Department of Physical Activity and Rehabilitation Sciences, University of Liège, Liège, Belgium; ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, University Hospital of Liège, Belgium
| | - Jean-Louis Croisier
- LAM - Motion Lab, University of Liège, Belgium; Department of Physical Activity and Rehabilitation Sciences, University of Liège, Liège, Belgium; ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, University Hospital of Liège, Belgium
| | - Vincent Denoël
- LAM - Motion Lab, University of Liège, Belgium; Department of Urban and Environmental Engineering, University of Liège, Liège, Belgium
| | - Olivier Brüls
- LAM - Motion Lab, University of Liège, Belgium; Department of Aerospace and Mechanical Engineering, University of Liège, Liège, Belgium
| | - Bénédicte Forthomme
- LAM - Motion Lab, University of Liège, Belgium; Department of Physical Activity and Rehabilitation Sciences, University of Liège, Liège, Belgium; ReFORM IOC Research Centre for Prevention of Injury and Protection of Athlete Health, University Hospital of Liège, Belgium
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Klich S, Kawczyński A, Sommer K, Danek N, Fernández-de-las-Peñas C, Michener LA, Madeleine P. Stiffness and thickness of the upper trapezius muscle increase after repeated climbing bouts in male climbers. PeerJ 2022; 10:e14409. [PMID: 36523451 PMCID: PMC9745787 DOI: 10.7717/peerj.14409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 10/27/2022] [Indexed: 12/12/2022] Open
Abstract
Background Indoor climbing involves overloading the shoulder girdle, including the rotator cuff and upper trapezius muscles. This on the field study aimed to investigate the effects of repeated climbing bouts on morphological and mechanical measures of the upper trapezius muscle. Materials and Methods Fifteen experienced male climbers participated in the study. Rate of perceived exertion (RPE), blood lactate concentration ([La-]b), and stiffness and thickness over four points of the upper trapezius were assessed before and after a repeated climbing exercise. The procedure for the climbing exercise consisted of five climbs for a total time of 5-minutes per climb, followed by a 5-minute rest. Results The analysis showed an increase from baseline to after the 3rd climb (p ≤ 0.01) for RPE and after the 5th climb for [La-]b (p ≤ 0.001). Muscle stiffness and thickness increased at all points (1-2-3-4) after the 5th climb (p ≤ 0.01). We found spatial heterogeneity in muscle stiffness and thickness; muscle stiffness was the highest at Point 4 (p ≤ 0.01), while muscle thickness reached the highest values at points 1-2 (both p ≤ 0.01). Moreover, the analysis between the dominant and non-dominant shoulder showed greater stiffness after the 1st climb at Point 1 (p = 0.004) and after the 5th climb at Point 4 (p ≤ 0.001). Conclusions For muscle thickness, the analysis showed significant changes in time and location between the dominant and the non-dominant shoulder. Bilateral increases in upper trapezius muscle stiffness and thickness, with simultaneous increases in RPE and blood lactate in response to consecutive climbs eliciting fatigue.
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Affiliation(s)
- Sebastian Klich
- Department of Paralympic Sport, Wrocław University of Health and Sport Sciences, Wrocław, Poland
| | - Adam Kawczyński
- Department of Paralympic Sport, Wrocław University of Health and Sport Sciences, Wrocław, Poland
| | - Klaudia Sommer
- Wroclaw University of Health and Sport Sciences, Wrocław, Poland
| | - Natalia Danek
- Department of Physiology and Biochemistry, Wrocław University of Health and Sport Sciences, Wrocław, Poland
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain,Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Madrid, Spain
| | - Lori A. Michener
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, United States of America
| | - Pascal Madeleine
- Department of Health Science and Technology, Sport Sciences—Performance and Technology, Aalborg University, Aalborg, Denmark
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Muscle fatigue response of rotator cuff muscles in different postures. Arch Orthop Trauma Surg 2022; 143:3191-3199. [PMID: 36305967 DOI: 10.1007/s00402-022-04650-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/08/2022] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Muscle fatigue is a leading cause of rotator cuff (RC) pathologies. Scapular orientation affected by changes in the thoracic spine account for differences in body postures leading to altered RC muscle activation. This posture-related alteration in RC muscle activation and its fatigue response needs to be analyzed. MATERIALS AND METHODS This study included 50 healthy shoulders with no coexisting spine pathologies. Raw data were recorded using electromyography sensors for RC muscles during two isometric maneuvers of abduction and external rotation, performed at 30% maximum voluntary contraction at 30°, 45°, and 90° arm elevation in sitting and standing. The raw data were analyzed in DataLITE® software, and the mean power frequency (MPF) was extracted to analyze the fatigue response of RC muscles. The Wilcoxon signed-rank test and Kruskal-Wallis test with Bonferroni corrections analyzed fatigue differences between postures and various activities. P < 0.05 was considered significant for the results. RESULTS Supraspinatus muscle demonstrated significant fatigue at 90° of arm elevation in standing as compared to sitting (MPF -5.40: -5.41; P = 0.03) posture. Between the three elevation angles, all the RC muscles showed increased fatigue at 90° (MPF range -5.22 to -6.64). When compared between abduction and external rotation, only infraspinatus showed fatigue in external rotation (MPF range -5.42 to -6.08). Among all the three RC muscles, infraspinatus showed the maximum fatigue of MPF -6.64 when compared to supraspinatus -5.22 and teres minor -5.36. CONCLUSION The findings indicate that alterations in the body postures and different elevation angles affect the RC muscles' fatigue response.
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Kim BG, Lim SK, Kong S. The Relationship between Scapular Upward Rotation and Shoulder Internal and External Rotation Isokinetic Strength in Professional Baseball Pitchers. Healthcare (Basel) 2021; 9:healthcare9060759. [PMID: 34207473 PMCID: PMC8233980 DOI: 10.3390/healthcare9060759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 12/12/2022] Open
Abstract
This study aims to assess the relationship between scapular upward rotation (SUR) across varying humeral-elevation angles (HEAs) and shoulder isokinetic strength and ratio in professional baseball pitchers. The subjects were professional baseball pitchers (n = 16) without a history of shoulder injury in the last six months. The subject’s SUR angles were measured with the humerus elevated at HEAs of 0° (at rest), 60°, 90°, and 120° to the scapular plane. Shoulder isokinetic strength was evaluated for shoulder internal rotation (IR) and external rotation (ER) strength (PT%BW and TW%BW), and the ER/IR strength ratios were determined at 60, 120 and 180°/s using an isokinetic dynamometer. The SUR angle at an HEA of 0° was positively correlated with IR strength at 120°/s (r = 0.535) and 180°/s (r = 0.522). The SUR angle at an HEA of 60° was negatively correlated with the ER/IR strength ratios at 60°/s (r = −0.505) and 120°/s (r = −0.500). The SUR angle at an HEA of 90° was negatively correlated with the ER/IR strength ratios at 60°/s (r = −0.574; r = −0.554) and 120°/s (r = −0.521; r = −0.589) as well as with ER strength at 180°/s (r = −0.591, r = −0.556). The SUR angle at an HEA of 120° was negatively correlated with ER strength at 60°/s (r = −0.558), 120°/s (r = −0.504; r = −0.524), and 180°/s (r = −0.543) and the ER/IR strength ratio at 60°/s (r = −0.517). In this study, we found that the ratio of isokinetic strength between ER and IR became closer to the normal range on increasing the SUR angle. In particular, an HEA of 90°, which resembles the pitching motion, showed a clear relationship between SUR, shoulder ER, and the ratio of ER/IR isokinetic strength in professional baseball pitchers.
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Affiliation(s)
| | - Seung Kil Lim
- Department of Exercise Prescription, Dongshin University, Naju 58245, Korea;
| | - Sunga Kong
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul 06351, Korea
- Patient-Centered Outcomes Research Institute, Samsung Medical Center, Seoul 06351, Korea
- Correspondence: ; Tel.: +82-02-2148-9498; Fax: +82-02-3410-6639
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Ventura R, Daley-Yates P, Mazzoni I, Collomp K, Saugy M, Buttgereit F, Rabin O, Stuart M. A novel approach to improve detection of glucocorticoid doping in sport with new guidance for physicians prescribing for athletes. Br J Sports Med 2021; 55:bjsports-2020-103512. [PMID: 33879477 DOI: 10.1136/bjsports-2020-103512] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2021] [Indexed: 01/13/2023]
Abstract
The systemic effect of glucocorticoids (GCs) following injectable routes of administration presents a potential risk to both improving performance and causing harm to health in athletes. This review evaluates the current GC antidoping regulations defined by the World Anti-Doping Agency and presents a novel approach for defining permitted and prohibited use of glucocorticoids in sport based on the pharmacological potential for performance enhancement (PE) and risk of adverse effects on health. Known performance-enhancing doses of glucocorticoids are expressed in terms of cortisol-equivalent doses and thereby the dose associated with a high potential for PE for any GC and route of administration can be derived. Consequently, revised and substance-specific laboratory reporting values are presented to better distinguish between prohibited and permitted use in sport. In addition, washout periods are presented to enable clinicians to prescribe glucocorticoids safely and to avoid the risk of athletes testing positive for a doping test.
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Affiliation(s)
- Rosa Ventura
- Catalonian Antidoping Laboratory, IMIM, Hospital del Mar Institute for Medical Research, Barcelona, Catalunya, Spain
| | - Peter Daley-Yates
- Clinical Pharmacology & Experimental Medicine, GSK, Brentford, London, UK
| | - Irene Mazzoni
- Science & Medicine Department, World Anti-Doping Agency, Montreal, Quebec, Canada
| | - Katia Collomp
- CIAMS, Université d'Orléans, Orléans, France
- Université Paris-Saclay CIAMS, Orsay, France
- Département des Analyses, AFLD, Chatenay-Malabry, France
| | - Martial Saugy
- REDs, Research and Expertise in antiDoping sciences, University of Lausanne, Lausanne, Switzerland
| | - Frank Buttgereit
- Department of Rheumatology and Clinical Immunology, Charité University Medicine, Berlin, Germany
| | - Olivier Rabin
- Science & Medicine Department, World Anti-Doping Agency, Montreal, Quebec, Canada
| | - Mark Stuart
- International Testing Agency, Lausanne, Switzerland
- Division of Medicine, Centre for Metabolism and Inflammation, University College London, London, UK
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Electromyographic Evaluation of the Shoulder Muscle after a Fatiguing Isokinetic Protocol in Recreational Overhead Athletes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052516. [PMID: 33802582 PMCID: PMC7967333 DOI: 10.3390/ijerph18052516] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/22/2021] [Accepted: 02/25/2021] [Indexed: 11/17/2022]
Abstract
The goal of our study was to examine the muscle activity of the shoulder girdle after isokinetic fatigue, which may simulate muscle activities commonly occurring during specific sport-related activities in recreational overhead asymptomatic athletes. We hypothesized that exercise-induced fatigue, reported after isokinetic protocols, may cause a decrease in the median frequency (MF) of the upper trapezius (UT), infraspinatus (IS), and deltoid muscles. Twenty-four male overhead volleyball (n = 8), handball (n = 8), and tennis (n = 8) athletes participated in this study. All subjects were without shoulder injury history. The surface electromyography (SEMG) was collected on the right (dominant) side of the shoulder girdle muscles in the following order: UT, IS and anterior (DA), and posterior deltoideus (DP). The fatigue protocol consisted of three sets of 32 maximum isokinetic concentric contractions while performing shoulder internal and external rotation at an isokinetic speed of 120 o/s. The resultant difference in median frequency (ΔMF) values consistently dropped after the fatiguing tasks across all recorded muscles, in terms of the initial MF (MFINI = 65.1 ± 1.1 Hz) and final MF (MFFIN = 57.9 ± 0.9 Hz), and the main effect of time was significant (F(1,22) = 43.15, p < 0.001). MF values decreased mostly for IS (ΔMFIS = −9.9 ± 1.6 Hz) and DP (ΔMFPD = −9.5 ± 1.9 Hz) muscles, while DA and UT showed smaller changes (ΔMFDA = −6.9 ± 1.5 Hz) and (ΔMFUT = −3.2 ± 1.3 Hz). The results of our study show a meaningful contribution in determining increased fatigue of the shoulder girdle muscles during repeated isokinetic internal-external rotation protocols. We have also demonstrated a significant decrease in MF in all examined muscles, especially IS and DA.
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