Muscular imbalance and shoulder pain in volleyball attackers.

OBJECTIVE: In overhead sports such as volleyball, baseball, or tennis shoulder problems are very common. The aim of this study was to identify features which may correlate with shoulder problems in volleyball attackers. METHODS: 30 competitive volleyball attackers (mean age 25 years) were included in the study; 15 were suffering from shoulder pain and 15 had no history of shoulder pain. The results were compared with those of a control group of 15 recreational athletes without any overhead sports activities. RESULTS: Volleyball attackers have a different muscular and capsular pattern at the playing shoulder compared to the opposite shoulder. Their playing shoulder is depressed, the scapula lateralised, and the dorsal muscles and the posterior and inferior part of the shoulder capsule shortened. These differences were of more significance in volleyball attackers with shoulder pain than in volleyball players without shoulder pain. In contrast to recreational athletes without any overhead sports activity, there were no significant difference in the comparison of the two shoulders. The histories, clinical and sonographic findings did not reveal further typical features for volleyball attackers with shoulder pain. CONCLUSIONS: Muscular balance of the shoulder girdle is very important in this sport. It is therefore imperative to include adequate stretching and muscular training programme for the prevention, as well as for therapy, of shoulder pain in volleyball attackers.

[Chronic shoulder pain in the volleyball attack player]. / Der chronische Schulterschmerz des Volleyballangriffsspielers.

30 competitive volleyball attackers of the German third league, 15 with shoulder pain (group I) and 15 without shoulder pain (group II) were examined clinically and sonographically. Anamnesis was also carried out. The results were compared with those of a control of 15 non-volleyball players not subject to stress caused by overhead use of their arms. On the visual analog scale the average pain was 5.1 (SD 1.4). The average history of pain was 2.7 (SD 2.7) years. Cause for the pain was "spiking without warming up" (n = 7) or "unknown" (n = 8). Spiking respectively serving caused new pain sensation in 14 (11) attackers. Players of group I stretched shorter than those of group II. Pain was located laterally to the greater tuberculum (n = 8), at the origin of the deltoid muscle (n = 3), at the bicipital groove (n = 2) or in the area of the ventral glenoid (n = 2). Pain was caused by active anteversion above 160 degrees (n = 3), active abduction above 140 degrees (n = 2) or both (n = 10). The playing shoulder was depressed in all 30 volleyball attackers. By measuring the distance from the epicondylus radii to the acromion of the other side by maximal forced horizontal adduction, the distance from the margo medialis scapula to the spine, the distance from the tip of middle finger to the lumbar spine by maximal internal rotation of the shoulder up the back showed significant differences between both sides and between the groups. The spiking arm scapula is significantly lateralised compared to the opposite side and compared to sportsmen.(ABSTRACT TRUNCATED AT 250 WORDS)

Bronchogenic carcinoma a review and study.

The preceding review of bronchogenic carcinoma and our own experience with lung cancer patients, indicate that long-term survival of these patients has only minimally improved. Advanced lung cancer does not significantly respond to the current treatment armamentarium, but present research and clinical trials of such new treatments as immunotherapy and interferon therapy may give hope for the future. At present our biggest weapon against lung cancer is still the elimination of cigarette smoking. Until we achieve this unlikely goal or greatly improve our success in treating the disease, we will need to continue our commitment to assist the patient with lung cancer in achieving the highest quality of life.

Part 1. Bronchogenic carcinoma a review and study.

Despite much research and clinical application of various treatment modalities, the five-year survival rate in bronchogenic carcinoma is very poor. With over 90,000 lung cancer deaths recorded in 1977, and over 100,000 deaths estimated in 1980, we should emphasize prevention as well as cure in our daily patient contacts. Patients particularly at high risk are (a) men over 45 years of age with more than 10 pack-years of smoking, (b) patients (men and women) with chronic cough, recent pneumonia, or hemoptysis. (c) Patients with a stable solitary nodule, (d) patients with occupational exposure. Hopefully, with prevention, early diagnosis, and improved treatment, our role in management of the lung cancer patient will be easier. Management of the patient with bronchogenic carcinoma will follow in the second part of this article.