著者

見目 智紀 落合 信靖 山崎 博範 西須 孝 森石 丈二

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.35, no.2, pp.593-596, 2011 (Released:2011-11-02)

参考文献数

8

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The purpose of this study was to investigate the relationship between the loss of thoracic mobility and the stiffness of neck and shoulder. 61 persons (19 males, 42 females) who had no functional disorder in their shoulder were involved in this study. The average age was 34.0 ± 11.1 years old. The method of manipulation where we flex the subject's thoracic spine while holding the neck of the subject was the only maneuver in this study. We assessed VAS and place of the stiffness, change of sagittal spinal curvature in standing and banzai posture. The pop sound in the thoracic joint was obtained in 54 subjects. After the treatment, VAS was significantly decreased from 44.1 ± 29.8 to 18.8 ± 17.6. Among 29 persons feeling neck stiffness, 26 had improved. Among 44 feeling stiffness around upper scapula, 42 had improved. Among 14 feeling stiffness of medial scapula, 13 had improved. 2 felt stiffness on the scapula, 1 was improved after treatment. There was no significant difference between before and after manipulation in thoracic kyphosis, lumber lordosis and inclination of standing. But there was a significant relationship between the range of motion of the thoracic spine and VAS after manipulation. The improvement of the thoracic mobility induced significant improvement in the neck and shoulder stiffness. This result suggested the postural control disorder by the loss of thoracic mobility was one of the important factors of neck and shoulder stiffness.

著者

松木 圭介 菅谷 啓之 前田 和彦 森石 丈二 望月 智之 秋田 恵一

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.31, no.2, pp.213-215, 2007

被引用文献数

7

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The purpose of this study was to examine the anatomy of the infraspinatus including the orientation of muscle fibers and the insertion to the greater tuberosity. Ninety-three shoulders from 52 cadavers were minutely dissected. After resection of the acromion and removal of the coracohumeral ligament, the infraspinatus muscle was carefully investigated macroscopically. After the orientation of muscle fibers was confirmed, the muscle was peeled from the proximal part to the distal part and the insertion of the infraspinatus tendon was examined. In 4 shoulders, muscle fibers were completely removed in water and the direction and insertion of the tendon were examined. The infraspinatus muscle originated both from the inferior surface of the spine of the scapula and the infraspinatus fossa, and inserted to the greater tuberosity. The muscle fibers originated from the spine were running dorsally and horizontally to the greater tuberosity. On the other hand, the fibers from the fossa were running ventrally and diagonally to the greater tuberosity. These fibers were merged at the insertion. The infraspinatus tendon had vast insertion to the greater tuberosity, and the most anterior part of the tendon was inserted to the most anterior portion of the greater tuberosity, bordering on the most anterior part of the supraspinatus tendon. The supraspinatus tendon is regarded as the most affected tendon in rotator cuff tears. However, the results of this study suggested that the infraspinatus tendon could be involved in the majority of rotator cuff tears. The infraspinatus may act not only in external rotation but also in abduction, because the infraspinatus tendon was inserted to the most anterior part of the greater tuberosity.

著者

戸野塚 久紘 菅谷 啓之 高橋 憲正 河合 伸昭 中島 亮 寺谷 威 真鍋 博規 安藤 晃 森石 丈二

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.35, no.3, pp.877-881, 2011 (Released:2011-12-21)

参考文献数

13

被引用文献数

1

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The purpose of this study is to determine a target ROM (T-ROM) at 3 months after arthroscopic rotator cuff repair, by which patients can expect eventual full recovery. Subjects consist of 209 shoulders in 202 patients, including 116 males and 86 females with an average age of 61.5 years old, who underwent primary arthroscopic rotator cuff repair and were followed-up for a minimum of 2 years. There were 30 partial-thickness tears, 120 small to medium and 57 large to massive full-thickness tears. Anterior elevation (AE), external rotation at side (ER), and internal rotation (IR) ROM at 3 month after surgery (ROM-3M) were measured, and divided into five groups according to the values. The final ROM at 24 months after surgery was compared with each ROM-3M of these subgroups in order to determine the T-ROM. Then, according to the T-ROM, patients were also divided into two groups: less than the T-ROM (AE-, ER-, and IR-); and more than the T-ROM (AE+, ER+, and IR+), and average ROM in each group were compared with each other. The final ROM of AE was significantly better in the group of more than 120° than less than 120 degrees. Therefore, the T-ROM of AE was determined as 120°. Similarly, those of ER and IR were determined as 10° and L5 level. ROM at 6 and 9 months in the AE+ group was significantly better than those of the AE- group. Further, every ROM at 3 to 24 months in the ER+ group was significantly better than those of the ER- group. In conclusion, ROM at 3 months after surgery affects final shoulder function. Surgeons and therapists should pay attention to the T-ROM at 3 months after surgery described above in order to maximize patients's final shoulder function.

著者

西須 孝 高橋 謙二 藤田 耕司 三橋 繁 森石 丈二

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.23, no.2, pp.293-296, 1999-07-30 (Released:2012-11-20)

参考文献数

6

被引用文献数

1

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The purpose of this study is to evaluate the effects of extracorporeal shockwaves on chronic calcific tendinitis of the shoulder. We studied 4 patients with chronic calcific tendinitis of the shoulder. Extracorporeal shock wave therapy was applied using Dornier Epos (Dornier Company, Germany). The JOA score, the VAS score (resting pain, night pain and tenderness) and plain radiographs before and after the shock wave treatments were studied in 4 shoulders.The average JOA score was 55.5 points (range,37-70 points) just before the start of the shock wave application. At the end of this study and over-three months after the shock wave application, it was 75.5 points (range,57-98 points). The VAS scores were decreased in all 4 patients after the shock wave application. The areas of calcification were reduced in 3 out of 4 shoulders. We concluded that extracorporeal shock wave therapy was useful for chronic calcific tendinitis of the shoulder.

著者

河合 伸昭 菅谷 啓之 高橋 憲正 戸野塚 久紘 中島 亮 寺谷 威 真鍋 博規 安藤 晃 森石 丈二

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.35, no.3, pp.903-906, 2011 (Released:2011-12-21)

参考文献数

14

被引用文献数

2

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Primary frozen shoulder is believed to be a self-limited disease. However, many patients complain of prolonged symptoms such as night pain and refractory stiffness. The purpose of this study is to estimate the efficacy of steroid injection to the glenohumeral joint for primary stiff shoulder associated with night pain. Subjects consisted of 115 consecutive patients, including 37 males and 72 females with an average age of 59.4 years old, who were diagnosed as having primary frozen shoulder at the shoulder clinic in our institute from May to November, 2009. Our treatment principles are as follows: we recommend patients who complain of night pain to keep their arm at rest and carry out trunk and scapular exercises, in addition to steroid injection to the glenohumeral joint once a week until the night pain subsides. Then, physiotherapy is initiated of the hand of therapists. Range of motion at the first visit and at the time when the night pain disappeared was evaluated, as well as that at the final follow-up which was 5.8 months on average.The mean forward flexion, external and internal rotation significantly improved when the night pain disappeared, which was 4.8 weeks on average, from 97.5, 9.2°, and S level to 117.5, 17.4°, and L4 level. The range of motion at the final follow-up was 144 degrees in flexion, 31 in external rotation, and L2 level in internal rotation.Steroid injection to the glenohumeral joint was effective for pain relief for patients with primary frozen shoulder associated with night pain. Removing inflammation at the glenohumeral joint is a key factor when treating such patients and this also enables patients to proceed with effective physiotherapy.

著者

森石 丈二 黒田 重史 住吉 徹是 斎井 政憲 李 鐘勲

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.15, no.2, pp.338-341, 1991-09-01 (Released:2012-11-20)

参考文献数

15

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Two cases of infraspinatus muscle atrophy in athletes were treated operatively. [case 1] A 21 year-old left-handed volleyball male player.We performed a two stage-operation on his left shoulder. At first we released the suprascapular nerve ( resection of the superior transverse scapular ligament, neurolysis and partial shaving of the base of the spinoglenoid ) and two months later, we performed a repair of the rotator interval.[case 2] A 17 year-old right-handed student pictcher.We perfomed decompression of the suprascap u lar nerve in the same way as in case 1.In all the operations, we found the supascapular nerve was swollen and inflamed at t h e region between the suprascapular and the spinoglenoid notch. In case 1, he was free of pain and able to resume of pitching successfully after surgery. In case 2 however, he got little relief of pain and was still weak. In his case, not only did he have suprascapular neuropathy but also disorders of the infraspinatus muscle.

著者

森石 丈二 黒田 重史 住吉 徹是 斎藤 政憲 丸田 喜美子 菅谷 啓之 石毛 徳之

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.20, no.1, pp.217-219, 1996-10-15 (Released:2012-11-20)

参考文献数

5

被引用文献数

3

著者

前田 和彦 菅谷 啓之 新井 隆三 森石 丈二 望月 智之 吉村 英哉 松木 圭介 秋田 恵一

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.31, no.2, pp.209-211, 2007

被引用文献数

5

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It is generally believed that the supraspinatus tendon plays an important role in the shoulder function. However, precise anatomy of the supraspinatus tendon has not been well described. The purpose of this study was to investigate the anatomy of the supraspinatus tendon. 57 cadavers (103 shoulders) were used for this study. The clavicle and humerus were cut off at their proximal parts. After resection of the acromion, the coracohumeral ligament was carefully removed. In some specimens, the infraspinatus was completely removed from the humerus to observe the overlapping portion of the supraspinatus and infraspinatus. The supraspinatus muscle and its origin were carefully investigated macroscopically. In 4 shoulders, muscle fibers were completely removed to examine the direction and insertion of the supraspinatus tendon in detail. The supraspinatus muscle fibers originated from the spine of the scapula and the supraspinatus fossa, and they were running toward and attached to the thickest tendinous portion, which was located at the anterior part of the supraspinatus muscle. This tendinous portion was strongly attached to the most anterior portion of the greater tuberosity adjacent to the bicipital groove or at the lesser tuberosity (21.3%). Another part of the supraspinatus, which was located posteriorly, was attached to the greater tuberosity adjacent to the articular cartilage as a thin membrane. The insertion of the supraspinatus tendon revealed to be the most anterior portion of the greater tuberosity and the lesser tuberosity. These results suggested that the supraspinatus tendon worked more efficiently as an abductor of the shoulder joint with the arm externally rotated than internal rotation.

著者

松木 圭介 菅谷 啓之 前田 和彦 森石 丈二 望月 智之 秋田 恵一

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.31, no.2, pp.213-215, 2007 (Released:2008-01-30)

参考文献数

6

被引用文献数

14

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The purpose of this study was to examine the anatomy of the infraspinatus including the orientation of muscle fibers and the insertion to the greater tuberosity. Ninety-three shoulders from 52 cadavers were minutely dissected. After resection of the acromion and removal of the coracohumeral ligament, the infraspinatus muscle was carefully investigated macroscopically. After the orientation of muscle fibers was confirmed, the muscle was peeled from the proximal part to the distal part and the insertion of the infraspinatus tendon was examined. In 4 shoulders, muscle fibers were completely removed in water and the direction and insertion of the tendon were examined. The infraspinatus muscle originated both from the inferior surface of the spine of the scapula and the infraspinatus fossa, and inserted to the greater tuberosity. The muscle fibers originated from the spine were running dorsally and horizontally to the greater tuberosity. On the other hand, the fibers from the fossa were running ventrally and diagonally to the greater tuberosity. These fibers were merged at the insertion. The infraspinatus tendon had vast insertion to the greater tuberosity, and the most anterior part of the tendon was inserted to the most anterior portion of the greater tuberosity, bordering on the most anterior part of the supraspinatus tendon. The supraspinatus tendon is regarded as the most affected tendon in rotator cuff tears. However, the results of this study suggested that the infraspinatus tendon could be involved in the majority of rotator cuff tears. The infraspinatus may act not only in external rotation but also in abduction, because the infraspinatus tendon was inserted to the most anterior part of the greater tuberosity.

著者

森石 丈二 住吉 徹是 黒田 重史 斉井 政憲

出版者

千葉大学

雑誌

千葉医学雑誌 (ISSN:03035476)

巻号頁・発行日

vol.69, no.2, 1993-04-01

著者

坂本 浩樹 平島 俊弘 遊佐 隆 黒田 重史 森石 丈二

出版者

公益社団法人日本理学療法士協会

雑誌

理学療法学 (ISSN:02893770)

巻号頁・発行日

vol.20, no.6, pp.407-410, 1993-11-01

被引用文献数

1

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腱板断裂の手術後の固定肢位として stockinette-Velpeau固定を用い, 理学療法をおこなった30例31肩に対し術前, 術後の成績を日本整形外科学会肩関節疾患治療成績判定基準に基づいて比較検討した。総合点は術前平均68.3点から術後平均95.4点と良好な成績が得られた。術前に高度な痛みを訴えていた者, 長時間上肢挙上作業に従事している者, 筋力の回復が遅い者に術後痛みが残存する傾向を認めた。術後患側を下にして寝る事のみ不能なものが 5肩に認められた。術後自動挙上はすべて15点, 自動外旋は平均 7.8点と良好な成績を示した。