The prediction of pitching injuries of the shoulder and elbow by comparing the ROM between dominant and non-dominant side on neck/trunk rotations and hip internal rotation / 体力科学

The pitching motion requires neck, trunk and hip rotations. The purpose of this study was to investigate the relationship between pitching injuries and dominant versus non-dominant differences of the ranges of these motions. The subjects were 66 high school baseball pitchers who received medical checkup during baseball classes in Kyoto prefecture. During medical checkup, physical therapists measured the ranges of neck/trunk rotations, and internal rotation of the bilateral hips. Then orthopaedic doctors did special tests such as shoulder internal impingement test, subacromial impingement test, elbow valgus stress test and elbow hyper extension test. Fourteen pitchers (21.2%) who were positive in one or more special tests were judged to require second screening (injured group). In normal group, average neck/trunk rotations toward the non-dominant side were significantly wider than rotations toward the dominant side. Average hip internal rotation was significantly wider on the non-dominant side than on the dominant side. In injured group, a larger number of pitchers had wider neck and trunk rotation ranges toward the dominant side than toward the non-dominant side, and had wide hip internal rotation range on the dominant side compared to the non-dominant side. Comparing the ranges of the neck/trunk rotations and hip internal rotation between dominant and non-dominant sides might be useful for the prediction of pitching injuries of the shoulder and the elbow.

Changes of the Muscle-tendon Lengths in a Three-dimensional Musculoskeletal Model according to the Hip Transverse Angle in Cerebral Palsy Patients with Crouch Gait / 대한정형외과학회잡지

PURPOSE: Crouch gait is one of the common pathologic gaits in children with cerebral palsy. Hamstring lengthening for alleviation of knee flexion is often considered as a first choice for the treatment of crouch gait. However, there have been a variety of reports about the lengths of the hamstring muscle. The purpose of this study was to classify the crouch gait on the transverse plane and to suggest a guide line for hamstring lengthening by analyzing the length of these muscles. MATERIALS AND METHODS: The subjects for this study were selected in ambulatory spastic diplegia patients with crouch gait. A total of sixty-two patients (124 cases) were included. The gait parameters and the muscle lengths were compared. The range of +/-1 standard deviation of the normal middle stance hip rotation was considered as the normal range. The subjects were divided into three groups as hip external rotated (group I), normal (group II) and hip internal rotated (group III) according to the hip rotation. RESULTS: The flexion of the knee and hip was the greatest in group III and dorsiflexion of the ankle was the least in group I. On comparison of moment and power on the sagittal plane, there was no significant difference among the groups. In group III, the percent lengths of the adductor, biceps femoris and gracilis muscles were increased the most, whereas the percent length of the semimembranosus was decreased the most. There was no statistical difference between groups I and II and the normal control group. CONCLUSION: Irrespective of the hip rotation, the length of the hamstring muscle in patients with crouch gait did not differ compared to that of the normal control. But if rotational osteotomy is done for the correction of the increased femoral anteversion in group III, then we should consider lengthening the semimembranosus muscle.