Sensorimotor Control of the Shoulder in Professional Volleyball Players With Isolated Infraspinatus Muscle Atrophy.

CONTEXT: Isolated infraspinatus muscle atrophy (IIMA) affects only the hitting shoulder of overhead-activity athletes and is caused by suprascapular nerve neuropathy. No study has assessed the static and dynamic stability of the shoulder in overhead professional athletes with IIMA to reveal possible shoulder sensorimotor alterations. OBJECTIVE: To assess the shoulder static stability, dynamic stability, and strength in professional volleyball players with IIMA and in healthy control players. DESIGN: Cross-sectional study. SETTING: Research lab. PATIENTS OR OTHER PARTICIPANTS: A total of 24 male professional volleyball players (12 players with diagnosed IIMA and 12 healthy players) recruited from local volleyball teams. INTERVENTION(S): Static stability was evaluated with 2 independent force platforms, and dynamic stability was assessed with the "Upper Quarter Y Balance Test." MAIN OUTCOME MEASURE(S): The static stability assessment was conducted in different support (single hand and both hands) and vision (open and closed eyes) conditions. Data from each test were analyzed with analysis of variance and paired t-test models to highlight statistical differences within and between groups. RESULTS: In addition to reduced abduction and external rotation strength, athletes with IIMA consistently demonstrated significant less static (P < .001) and dynamic stability (P < .001), compared with the contralateral shoulder and with healthy athletes. Closed eyes condition significantly enhanced the static stability deficit of the shoulder with IIMA (P = .04 and P = .03 for both hand and single hand support, respectively) but had no effect on healthy contralateral and healthy players' shoulders. CONCLUSIONS: This study highlights an impairment of the sensorimotor control system of the shoulder with IIMA, which likely results from both proprioceptive and strength deficits. This condition could yield subtle alteration in the functional use of the shoulder and predispose it to acute or overuse injuries. The results of this study may help athletic trainers and physical/physiotherapists to prevent shoulder injuries and create to specific proprioceptive and neuromuscular training programs.

A Scott bench with ergonomic thorax stabilisation pad improves body posture during preacher arm curl exercise.

We assessed whether the use of an ergonomic thorax stabilisation pad, during the preacher arm curl exercise, could significantly reduce the excessive shoulder protraction and thoracic kyphosis induced by the standard flat pad built into the existing preacher arm curl equipment. A 3D motion capture system and inclinometers were used to measure shoulder protraction and thoracic kyphosis in 15 subjects performing preacher arm curl with a plate-loaded machine provided with the standard flat pad. The same measures were repeated after replacing the flat pad with a new ergonomic pad, specifically designed to accommodate the thorax profile and improve body posture. Pad replacement significantly (p < 0.001) reduced shoulder protraction (from [Formula: see text] to [Formula: see text]) and thoracic kyphosis (from [Formula: see text] to [Formula: see text]), enabling postural and functional improvements within the entire spine, shoulder girdle and rib cage. The ergonomic pad may potentially allow a more effective training, prevent musculoskeletal discomfort and reduce the risk of injury. Practitioner summary: We have designed an ergonomic thorax stabilisation pad for the preacher arm curl exercise. The new ergonomic pad improves the poor posture conditions induced by the standard flat pad and may potentially allow a more effective training, prevent musculoskeletal discomfort, improve the breathing function and reduce the risk of injury.

Knee flexion with quadriceps cocontraction: A new therapeutic exercise for the early stage of ACL rehabilitation.

Quadriceps strengthening exercises designed for the early phase of anterior cruciate ligament (ACL) rehabilitation should limit the anterior tibial translation developed by quadriceps contraction near full knee extension, in order to avoid excessive strain on the healing tissue. We hypothesize that knee-flexion exercises with simultaneous voluntary contraction of quadriceps (voluntary quadriceps cocontraction) can yield considerable levels of quadriceps activation while preventing the tibia from translating forward relative to the femur. Electromyographic activity in quadriceps and hamstring muscles was measured in 20 healthy males during isometric knee-flexion exercises executed near full knee extension with maximal voluntary effort of quadriceps cocontraction and external resistance (R) ranging from 0% to 60% of the 1-repetition maximum (1RM). Biomechanical modeling was applied to derive the shear (anterior/posterior) tibiofemoral force developed in each exercise condition. Isometric knee-flexion exercises with small external resistance (R=10% 1RM) and maximal voluntary effort of quadriceps cocontraction yielded a net posterior (ACL-unloading) tibial pull (P=0.005) and levels of activation of 32%, 50%, and 45% of maximum voluntary isometric contraction, for the rectus femoris, vastus medialis, and vastus lateralis, respectively. This exercise might potentially rank as one of the most appropriate quadriceps strengthening interventions in the early phase of ACL rehabilitation.