International SportMed Journal - Volume 4, Issue 2, 2003
Volume 4, Issue 2, 2003
Persistent shoulder pain in a squash player : acute bracial neuritis ("Parsonage Turner Syndrome") : short articleSource: International SportMed Journal 4, pp 1 –5 (2003)More Less
This case highlights the atypical presentation of acute brachial neuritis or Parsonage Turner Syndrome, which usually presents as sudden onset of severe shoulder pain with loss of function. A 36-year-old squash player presented with a history of persistent left shoulder pain of insidious onset. On examination, he was found to have significant wasting, as well as weakness, on testing of the supraspinatus and infraspinatus muscles. Electromyography (EMG) confirmed denervation and showed some evidence of re-innervation of both infraspinatus and supraspinatus. Magnetic resonance imaging (MRI) showed no compressive lesion, but evidence of muscle denervation.
The repeatability of clinical and laboratory tests to measure scapular position and movement during arm abduction : research articleSource: International SportMed Journal 4, pp 1 –11 (2003)More Less
Background : There is evidence that abnormal scapular position and movement (scapular dyskinesis) is associated with shoulder pathology. However, the clinical and laboratory assessment of scapular dyskinesis, in particular the repeatability of tests used, has not been well described.
Research question : What is the repeatability of three tests that can be used for the evaluation of scapular displacement during arm abduction?
Type of study : Repeatability study.
Methods : Ten non-injured subjects (20 shoulders) performed three arm abduction tests to 45° and 90° on two separate occasions. The three tests were (1) a previously described Lateral Scapular Slide Test (LSST) measuring medio-lateral displacement of the inferior scapular angle from the midline, (2) a novel modification of the Lateral Scapular Slide Test (MSST) measuring medio-lateral displacement of the inferior scapular angles and the superior medial border of the scapula, and (3) a novel test of Scapular Mapping (SM) using a three-dimensional (3-D) motion analysis system measuring antero-posterior displacement of the inferior and superior scapula.
Results : The repeatability (intra-class correlation coefficient : ICC) for the LSST was 0.86 at 45°, and 0.85 at 90° abduction. The ICC for the MSST (superior medial border) was 0.65 from 0-45° and 0.79 from 0-90° abduction. The ICC for the MSST (inferior angle) was 0.73 from 0-45° and 0.56 from 0-90° abduction. The ICC for SM (superior marker) was 0.90 from 0-45° and 0.91 from 0-90° abduction, and SM (inferior marker) was 0.94 from 0-45° and 0.63 from 0-90° abduction.
Conclusion : The LSST is a repeatable test for determining medio-lateral inferior scapular angle displacement (r=0.85), the MSST is repeatable for superior scapular angle medio-lateral displacement (r=0.65-0.79), and SM is highly repeatable at 45° arm abduction for measuring antero-posterior scapular displacement (r=0.90-0.94).
Source: International SportMed Journal 4, pp 1 –10 (2003)More Less
Shoulder pain is a common cause of disability in overhead throwing athletes. However, the precise cause of this pain may not be immediately obvious and often cannot be explained by the classic primary subacromial impingement syndrome. Other causes, e.g. primary instability with secondary impingement, 'internal impingement', scapholunate advanced collapse (SLAC) lesions and superior labral anterior and posterior (SLAP) lesions, partial rotator cuff tears may be the cause of shoulder pain in the athlete. These conditions can be diagnosed by meticulous clinical examination and appropriate imaging studies. Initial management of these shoulder injuries is conservative. Only if a thorough and well-planned rehabilitation programme has failed should operative management be considered.
Source: International SportMed Journal 4, pp 1 –9 (2003)More Less
Recurrent shoulder instability is relatively common among male and female athletes. Instability results when there is a symptomatic loss of the ability to control glenohumeral motions during functional activities. The pathogenesis typically involves dysfunction of the static (osseous and capsulolabral) and/or dynamic (scapulothoracic and rotator cuff musculature) stabilising structures resulting from repetitive microtrauma. Manifestations may include apprehension, weakness, fatigue, reduced performance, and pain from secondary impingement. Shoulder instability is classified according to aetiology, onset, direction and degree. Successful treatment is predicated upon a complete history, physical examination, and appropriate diagnostic testing. Non-operative management is typically warranted for 3-6 months and focuses upon activity modification, postural correction, restoration of normal shoulder mechanics, strength-endurance training of the shoulder girdle musculature, and optimisation of neuromuscular control. Although non-operative treatment is successful in many cases, surgery may be warranted in refractory cases. In the appropriately selected athlete, satisfactory results can be obtained utilising either open or arthroscopic surgical techniques.
Author Seung-Ho KimSource: International SportMed Journal 4, pp 1 –13 (2003)More Less
The recurrence rate after acute, first-time instability of the shoulder joint is high, particularly in young people (i.e. under 20 years old). Non-operative treatment does not guarantee consistent results. Early stabilisation clearly benefits young athletes. Arthroscopic repair of the Bankart lesion in the shoulder can reduce recurrence, improve outcome, and avoid the frequent necessity for open, constructive procedures to treat recurrent instability.