著者

菅原 誠 荻野 利彦 三浪 明男 福田 公孝 中里 哲夫

出版者

Japan Shoulder Society

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.10, no.1, pp.68-71, 1986

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Shoulder pain is the most common problem in sports which require throwing motion. The causes of shoulder pain are resulted to tendinitis, bursitis, recurrent anterior dislocation and impingement syndrome in many cases. During a 15-Year period, from 1960 through 1985, we encounterd 8 patients with axillary nerve palsy according to throwing motion. The average age of these patients was 17years (range 13 to 20 years). All were students participating in a sports (Baseball: 2, Volleyball: 2, Table tennis: 1, Basketball: 1, Tennis: 1, Badminton: 1). Symptoms began with onset of pain and paresthesia around the shoulder without trauma in all patients. The point tenderness was always found posterioly in the quadrilateral space. Many patients had a normal range of motion of the shoulder. Sensory disturbance of the axillary innervated area and motorloss of deltoid muscle was minimun in all patients. Length of free from shoulder pain ranged from 2 weeks to 6 months with an average length of 2.7 months. Electromyographies were performed on five patients. The deltoid was observed for reduced interference patterns and polyphasic potentials. The surface electromyograms during throwing motion were recorded from the muscles around the shoulder. The contraction of teres major and the long head of the triceps was observed during acceleration to the beginning of follow through phase. We suspected the causes of axillary nerve palsy according to throwing motion were considered following: the shoulder in abduction, extention, external rotation during wind up phase causes stretching and entrapment of axillary nerve in quadrilateral space and in abduction, flexion, internal rotation during acceleration phase causes further entrapment by contraction of teres major and the long head of the triceps. This report indicate that a player who require throwing motion could sustain a injury to axillary nerve and this injury is not so rare and has been neglected.