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

---

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

宮沢 知修 松井 健郎 小川 清久

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.13, no.2, pp.247-251, 1989-11-01 (Released:2012-11-20)

参考文献数

5

---

Objective: It has been reported that the acromiohumeral interval (hereafter referred to as AHI) narrows in rotator cuff tears (RCT). In many cases, however, it does not. In this study we re-examined the clinical significance of the AHI.Subjects and method: AHI was studied in the f ollowing: normal shoulders, as the control group,55 cases,55 shoulders; RCT (massive: 45·46; complete: 62·64; partial: 51·52), periarthritis: 57·66, and unstable shoulder: 63·85. The AHI was measured as the distance between the humeral head and the under surface of the acromion in a standingposition A-P view (internal and external rotations and neutral position) and scapular Yview.Results: In normal shoulders the internal rotation AHI was the widest, at 8-16 mm (average 11.3 mm), indicating a significant difference from other roentgenographic directions and measurement values. Concerning the neutal-position measurements in normal shoulders and each disease condition, the AHI was 3-12 mm (average 6.9 mm) for the massive tear group, and this represented the most narrowing found and was significantly different from all of the other groups measured.Conclusion:1) The AH I in normal shoulders expands with internal rotation and narrows with external rotation.2) In AHI measurements, important considerations are consistency of the positioning and the angle of roentgenography, and the most appropriate view is the neutral position.3) With a roentgenographic method in standing-position, the AHI measu r e ment is clinically significant only in diagnosing a massive RCT.4) As a diagnostic standard for a massive RCT, an AHI of 6 mm or less is appropriate, but allowances should be made for 52% of false negatives and approximately 18% of false positives.

著者

浜田 純一郎 山口 光國 筒井 廣明 前田 健 近 良明

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.36, no.2, pp.725-729, 2012 (Released:2012-10-25)

参考文献数

6

---

Background: The understanding of the glenohumeral (GH) joint motion during baseball pitching should be necessary for diagnosis and treatment for throwing shoulder. The purposes of this study were firstly to investigate the motions of the scapula, pelvis, upper body, and upper limbs and secondly to speculate the motion of the GH joint and the scapula from the top position to ball release.Methods: We observed the pitching of 2 professional and 2 high-level amateurs with a digital camera and a video camera, recording each motion of the pelvis, upper body, scapula, and upper limbs. We classified pitching motion into 3 phases which were slide, upper body rotation, and arm throwing in order to simply analyze the motion in each phase.Results: Each scapula protracted and retracted respectively during pitching motion. The pelvis which was closed in the stride, ball release, and follow-through synchronized with scapular motion. The throwing arm moved in the scapular plane and made the elbow extend to the ball release. Internal rotation of the humeral head was a little from the top position to the ball release.Discussion: Both scapula and pelvis synchronized at each phase of pitching motion. The motion of the GH joint was speculated to be a small amount from the top position to ball release.

著者

村田 亮 黒田 重史 石毛 徳之 荻野 修平 三笠 元彦

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.36, no.3, pp.1015-1018, 2012 (Released:2012-10-25)

参考文献数

11

---

Background: The scapula rotates upwardly during shoulder elevation. If the rotation center wasn't fixed on the scapula but on the humeral head, the movement of the glenoid would be regarded as the rotation along the humeral head. We have analyzed throwing shoulder injury cases using this concept of “functional glenoid”.Methods: Patients with throwing shoulder injury (TSI group; n=22) and normal control (n=8) were included in the study. Two radiographs were taken of each subject (anteroposterior in internal rotation; IR1, zero position). Two straight lines were drawn from the superior and inferior tubercle to the center of the humeral head in IR1 image, and the angle of the lines was measured (α angle). The TSI group was divided to two groups according to slipping of the humeral head in zero position images. The difference of the glenoid inclination angles between IR1 and zero position (β angle) were then measured, and the glenoid extension ratio (α+β/α) was calculated. Each set of data was statistically evaluated.Results: In the TSI group, β angle and the glenoid extension ratio did not show significant difference compared to the control group, but the slipping-negative cases showed significantly larger β angle than slipping-positive cases and the control group.Discussion: These results may be derived from multifactorial pathology of throwing shoulder injury. Significantly large β angle in slipping-negative TSI cases may indicate an adaptive pattern of movement of the scapula. The glenoid extension ratio could not reflect the scapular kinematic change of throwing shoulder injury.

著者

橋本 卓 金谷 整亮 池田 均 塚西 茂昭 信原 克哉 田中 道夫

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.14, no.2, pp.245-248, 1990-09-01 (Released:2012-11-20)

参考文献数

4

---

We have measured the intra-articular pressure simultaneously with arthrography of the shoulder. In this study, changes in the intra-articular pressure were examined in unstable shoudlers associated with loose shoulder, rotator interval lesion, and traumatic recurrent anterior dislocaiton.Of the 731 shoulders (731 patients) in which intra-articular pressure was me a sured from 1981, the measurement was possible in 254 shoulders (254 patients). A total of 91 shoulders, consisting of 20shoulders with traumatic recurrent anterior dislocation,40 loose shoulders, and 31 shoulders with rotator interval lesion, were evaluated.Physiologic saline was in f used into the joint, and canges in the intra-articular pressure were recorded as electric signals through a transducer. The arm was moved up and down passively, and the pressure was measured at intervals of 10.In loose shoulder and rotator interval l e sion, the intra-articular pressure decreased as the arm was lifted higher, but the decreases were smaller than in normal shoulders. In these groups, there was a smaller pressure increase to the position of maximum uplift with a smaller peak value and within a narrower range than in the normal group. These findings were more notable in the shoulders with an FSH angle of 81' or greater. These results suggest that the intra-articular pressure reflects the joint capacity.In traumatic recurrent anterior dislocation, however, the decrease in the pressure in an early stage of arm lifting was the greatest among all groups including the normal group, and the pressure increase with arm lifting was gentler in shoulders with an FSH of 80 °or less, unlike in the other two groups.The changes in the intra-articular pressure in shoulders with traumatic recurrent anterior dislocation may be explained by disruption of the anterior capsular mechanism and muscle contraction due to anxiety over the possibility of dislocaiton during arm lifting as well as the looseness of the articular capsule.

著者

小松田 辰郎 佐藤 克巳 成重 崇 熊谷 純 石橋 弘二

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.25, no.2, pp.305-308, 2001-08-02 (Released:2012-11-20)

参考文献数

8

被引用文献数

2

---

[Purpose]The present study was undertaken to elucidate the pathological conditions of both the capsule and subacromial bursa of contracted shoulders associated with rotator cuff tears.[Materials and methods]Twenty-six shoulders of 26 patients,22 males and 4 females, aged from 37to 75 years old (mean 57) received brisement procedures prior to cuff surgeries. There were 8 large,12 small and 6 partial thickness tears. Arthroscopic observation was done to find out the site of the capsular injury after the brisement procedures. Macroscopic observation of torn cuffs and the adhesion of the bursa were also performed.[Results]Arthroscopic findings after brisement procedures revealed redness, proliferations, and bleeding of the synovium in the glenohumeral joint. There were two types of capsular injuries. TypeA: tear of the axillar region(17 shoulders), Type B: tear of the axillar and rotator interval regions(9 shoulders). The number of cases of (Type A: Type B) was (7: 1) with large tears, (6: 6) with small tears and (4: 2) with partial thickness tears. If cuff tears included the rupture of the anterior band of the supraspinatus tendon, the number of (Type A: Type B) was (12: 3), while it was (1: 4) without a rupture of the band. Although there were adhesions between the bursa and cuff in 85% shoulders, no disruptions were found in the subacromial bursae.[Conclusion]The main cause of a shoulder contracture assosiated with rotator cuff tears was located at the axillar and rotator interval capsules and was influenced by the size of the location and cuff tears.

著者

岩堀 裕介 加藤 真 佐藤 啓二 花村 浩克

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.27, no.2, pp.415-419, 2003-08-20 (Released:2012-11-20)

参考文献数

18

被引用文献数

9

---

We measured the range of internal and external rotation of the shoulders and evaluated the effect of shoulder stretching in little league baseball players. Physical examinations were performed on fifty-two little league baseball players (range of age, nine to twelve years old), and measurements of the range of shoulder rotation were made with the patients supine and the shoulder at 90° abduction. Twenty-nine players, themselves and their partners were shown how to shoulder stretch and the effect of the stretching was evaluated. They demonstrated a significantly increased external rotation and a significantly decreased internal rotation range of motion compared with the opposite shoulders. The significant differences were found in all ages. Self stretching showed the least effect, while significant increased internal rotation was obtained by partner stretching. We found a significant loss of internal rotation of the throwing shoulders even in little league baseball players. Partner stretching was useful for recovery of the motion loss.

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

---

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

森澤 豊 川上 照彦 山本 博司 貞広 哲郎

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.117-121, 1996-10-15 (Released:2012-11-20)

参考文献数

6

---

The pathogenesis of a rotator cuff lesion of the shoulder is still controversial.The authors investigated the mechanoreceptors in the rotator cuff, the subacromial bursa and the coracoacromial ligament in order to clarify the proprioception of the shoulderjoint.

著者

林田 賢治 中川 滋人

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.29, no.3, pp.651-654, 2005-08-10 (Released:2012-11-20)

参考文献数

9

被引用文献数

4

---

The aim of this study was to elucidate the relationbetween internal (IR) and external rotations (ER) strength of the shoulder and shoulder pain during throwing in high school baseball pitchers. Internal and external rotation strength of the shoulder were measured in 401 high school pitchers, who had attended the national inter high school baseball tournament in Japan, and the influence of internal and external rotation strength of shoulder on shoulder pain during the throwing were assessed. The average IR and ER strength were 105.3+/-32.2N and 93.1+/-28.3N. The average IR. ER, and ER/IR ratio were 1.18+/-0.22,0.98+/-0.14, and 0.92+/-027, respectively, in all pitchers. All pitchers were classified into two groups. The pain experienced group (P group), which involved the pitchers who had experienced shoulder pain during throwing prolonged more than one month within the year, included 40 pitchers, and the other group (NP group) included 361 pitchers. The IR, ER, IR ratio, ER ratio, and ER/IR ratio were compared between both groups. The ER/IR ratio of the P group was lower than that of the NP group, with a statisticaldifference by unpaired student t-test (p=0.02). Pitchers with a low ER/IR ratio tend to injure their throwing shoulder and proper ER/IR ratio could be one of important condition for throwing shoulders.

著者

堀 克弘 吉川 玄逸 平岡 誠司 松末 吉隆 村上 元庸

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.27, no.3, pp.455-458, 2003-10-30 (Released:2012-11-20)

参考文献数

7

被引用文献数

1

---

A rupture of the rotator cuff tendon may induce muscular fatty degeneration, which can be observed with computed tomography (CT) imaging. The purpose of this study was to examine the frequency of fatty degeneration in patients with a complete rotator cuff tear using CT images.Twenty shoulders in twenty eight patients (average age sixty point seven years old ) with a complete cuff tear were studied. Fatty degeneration was evaluated using CT images and assessed by Goutallier's classification. The diagnosis of rotator cuff tear was made by the examiner, after which the frequency of fatty degeneration was determined. Supraspinatus tendon ruptures were found in eleven patients, infraspinatus tendon ruptures in two, supraspinatus and infraspinatus tendon ruptures in six, supraspinatus and subscapularis tendon ruptures in eight, and all three tendons were found ruptured in three. The frequency of fatty degeneration in the infraspinatus tendon was 66.7%, while that in the supraspinatus and subscapularis tendons was 35.7% and 23.1%, respectively. Some reports have concluded that postoperative results for rotator cuff repair are inferior when fatty degeneration has occurred, thus, it is best if surgery can be performed prior to its appearance. From the results of the present study, we considered that fatty degeneration is more prevalent with the infraspinatus tendon. Therefore, when a rupture of the this tendon is suspected, an operation should be carried out as soon as possible.

著者

北村 歳男 高木 克公 山鹿 眞紀夫 森澤 佳三 井手 淳二 荒木 崇一 田上 学

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.18, no.1, pp.1-4, 1994-09-01 (Released:2012-11-20)

参考文献数

8

被引用文献数

1

---

The purpose of this research was to clarify the causes of numbness and pain by traction of the upper limbs. We stretched the nerves in the upper limbs of rats by utilizing the flail of the shoulder girdle, and measured the blood flow of the brachial plexus and the median nerve. The model animals,32 wistar rats, were inserted with steel lines to the radius and ulna. These steel lines were drawn in the direction of a shoulder abduction of 80 degrees. A decrease and recovery of the blood flow were measured using the hydrogen gas clearance method.The blood flow of the subepineural space in the brachial plexus decreases sharply in conditions with looseness of the plexus.The blood flow of the intrafuniculuse in the brachial plexus decreases like a straight line in those states without looseness of the plexus. The blood flow of the subepineural space in the median nerve decrease like a straight line, too. The decrease rate of the subepineural space was sharper than that of the intrafuniculuse. As for the recovery rate, there was no significant difference in either site.One of the factor that causes nervous and functional imbalance with a slight traction is a sharp reduction of the blood flow in the subepineural space of the brachial plexus.

著者

村上 元庸 牧川 方昭 前野 幹幸 畑 正樹 七川 歓次

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.10, no.1, pp.22-24, 1986-07-28 (Released:2012-11-20)

---

When abducting the arm, the scapula and the humerus move cooperatively. This cooperation is known as “scapulohumeral rhythm”, and a constant relationship is said to exist between the abduction angle of the humerus and that of the scapula.But since the glenoid is too small to support the humeral head, it may happen that the humeral head will be dislocated or the soft tissue, like tendons or capsule, will be exposed to a excessive load, if the resultant force through the humeral head does not directly face to the glenoid. So we guess that a change of the resultant force which is consist of load and muscle power to the humerus may change the incline of the glenoid even at the same humeral abducting angle.In this study, we investigated the relationship between the glenoid inclination angle and the humeral abduction angle with or without block of the supraspinatus muscle power by the suprascapular nerve block.The subjects of this experiment was 5 healthy men, and the angle was measured by X-ray films which were taken at every 45 degrees abduction position with voluntary effort to abduct isometrically before and after the nerve block, and also the abduction torque was measured simultaneously by the Cybex- II.The result was that the inclination angle of the scapula was decreased after block, as the maximum defference at 90 degree abduction by 6 degree. And the torque was decreased by the mean of 25 %.From our hypothesis that the resultant force faces the glenoid perpendicularly, these results could be explained by the functional anatomy of the supraspinatus tendon. At 0 and 135 degree abduction the supraspinatus runs perpendicularly to the glenoid, so the resultant force does not change the direction after block. But at 90 degree abduction the position of the insertion of the supraspinatus is the highest of all abduction angle, so it acts to pull down the head. The resultant that force after block changes the direction upward, and so the glenoid inclination angle decreases to face the head.From these results, we guess a resultant force to the humeral head always faces to the glenoid by controlled constraction of the muscles around the shoulder.

著者

柴田 陽三 竹下 満 高岸 直人

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.10, no.1, pp.36-40, 1986-07-28 (Released:2012-11-20)

---

Intra-articular pressure (1-A pressure) of the gleno-humeral joint (G-H Joint) was measured in order to elucidate the mechanism of shoulder joint. (Material and Method)Ten normal subjects were measured. Fluidfilled teflon tube, with two small perforations around tip, was inserted into the axillary pouch from anterior aspect of the shoulder joint. The end of tube was connected to a pressure transducer. Intra-articular pressure was measured during movement of the shoulder joint when subjects were sitting position.(Result) When none of saline was injected into the gleno-humeral joint, there was almost no change of intar-articular pressure. But, when 10 ml and 20 ml of saline were injected into G-H joint, I-A pressure rose at shoulder elevation. I-A pressure with 20 ml of saline was higher and rose more steeply at the same elevated position. It was demonstrated that 1-A pressure was highest at full elevation. The relationship of I-A pressure and joint position before and after full elevation demonstrated that the pressures were lower than for the same joint position before full elevation.There were peak pressures at the full internal rotated position and the full externa l rotated position, but latter was higher than the former. The lowest value of I-A pressure was showed at the slightly flexed, abducted and internal rotated position.And further measurements were done in the disease joints.

著者

土肥 潤二 村上 元庸 吉川 玄逸 福田 眞輔

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.19, no.1, pp.108-111, 1995-05-20 (Released:2012-11-20)

参考文献数

8

被引用文献数

1

著者

山口 光國 筒井 廣明 山本 龍二 三原 研一 保刈 成 鈴木 一秀 上里 元 大島 和 内川 友義 菅 直樹 牧内 大輔

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.2, pp.325-328, 1996-11-30 (Released:2012-11-20)

参考文献数

4

---

PurposeWe investigated the muscle strength of the scapulothoracie joint which is apt to be affected by the position of other joints.

著者

筒井 廣明 山口 光國 山本 龍二 三原 研一 保刈 成 鈴木 一秀 上里 元 大島 和 内川 友義 菅 直樹 牧内 大輔

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.2, pp.337-340, 1996-11-30 (Released:2012-11-20)

参考文献数

6

被引用文献数

1

---

[Purpose]Cuff exercises are usually performed to improve the shoulder function and to keep the condition of the shoulder of throwing athletes. Thus, there are a large number of athletes who could not acquire the expected effects of the exercises. In this study, we examined the estimation of the cuff function and the daily exercises of the athletes electromyographically.

著者

浜田 純一郎 大野 弥 玉井 和哉

出版者

日本肩関節学会

雑誌

肩関節 = Shoulder joint (ISSN:09104461)

巻号頁・発行日

vol.26, no.2, pp.309-314, 2002-01-01

参考文献数

8

---

The purpose of this study was to identify whether the glenohumeral joint (GHj) or subacromial bursa (SAB) is the main inflamed site, and which pathway should be operated on for the degradation of the articular cartilage after a cuff tear. We obtained synovial fluid, SAB, the stump of a torn supraspinatus tendon (cuff), synovium, and articular cartilage (cartilage) from 8 patients with a complete-thickness tear. As a control, the cuff and cartilage were removed from 2 patients with tumors around the shoulders. We measured the concentration of interleukin-1 β (IL-1 β), IL-6, matrix metalloproteinase-1 (MMP-1), MMP-3. Immunohistochemical localization with antibodies to proliferative cell nuclear antigen (PCNA), IL-1 β, IL-6 and MMP-3 was performed using the ABC immunoperoxidase method. Concentrations of IL-1 β were 4.8±4.3 pg/ml, IL-6 485±4.3 pg/ml, MMP-1 417±330 ng/ml, MMP-3 6105±4258 ng/ml. A few nuclei were stained by PCNA but no cell by IL-1 β, IL-6, or MMP-3 in the control tissues. IL-1 β immunoreactivity was highest in the following order synovium, cuff, SAB, and cartilage ; for IL-6 the order was synovium, cuff, and SAB ; for MMP-3 in the order was synovium and cuff. Even though we found the same pathological findings (hyperplasia and abundant blood vessels) between the SAB and the synovium, expression of both IL-1 β and MMP-3 were much higher in the synovium than in the SAB. We conclude from these results that GHj is the main inflamed site after a cuff tear, and the extrinsic pathway is more greatly operated than the intrinsic pathway to cartilage degradation.

著者

小松 泰喜 石川 知志 片山 直樹 武藤 芳照

出版者

日本肩関節学会

雑誌

肩関節 = Shoulder joint (ISSN:09104461)

巻号頁・発行日

vol.26, no.2, pp.333-336, 2002-01-01

参考文献数

9

被引用文献数

1

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Swimming is generally accepted as a sport with minimal physical injuries. However, swimmers frequently complain of shoulder pain, termed &rdquo;swimmer's shoulder&rdquo;, which is thought to be a form of overused disorder. We investigated the factors related to shoulder pain in a cohort of elite swimmers in an attempt to isolate causes of this disorder. The subjects include 123 swimmers selected to participate in the Japan swimming championships between 1996 and 2000. Each participant had undergone complete medical examinations at the time of their competition. A study questionnaire was employed which asked the subject to grade the severity of their shoulder pain asked whether they trained with paddles and flippers, practiced any weight training, tubing and swim bench, did any stretching, and asked them to describe the type of swimming events in which they participated. The McNemar test and chi-square test were used in the statistical analysis. The incidence of shoulder pain was higher in swimmers who used paddles and flippers (p<0.01) and pain occurred more frequently during the weight training (p<0.01). Swimmers who stretched experienced a lower incidence of shoulder pain (p<0.01). There were no significant relationships between the shoulder pain and the type of swimming events or the practice of tubing and swim bench. : The use of the paddles and flippers as a training method needs to be investigated further as this appears statistically related to the development of &rdquo;swimmer's shoulder&rdquo;, a frequently cited overuse disorder among the swimming population. Furthermore, the practice of performing stretching exercises appears to prevent shoulder pain in this population and should be included, as part of the warm-up routine.

著者

伊崎 輝昌 緑川 孝二 柴田 陽三 緒方 公介 原 正文

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.18, no.1, pp.5-11, 1994-09-01 (Released:2012-11-20)

参考文献数

12

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PurposeBiceps labrum complex (BLC) lesions most commonly occur during sports activities in which the arm is frequently held in an overhead position. Among the available literature there are few histological studies about BLC. The purpose of this study was to demonstrate the anatomy of BLC and its attachment to the glenoid and to evaluate the results of our treatment for BLC lesions.Materials and MethodsAnatomical Study: Sixty shoulders from 30 cadavers were studied. We recorded the appearance of the glenoid labrum and the LHB. Then, we removed the glenoid process from the scapula leaving all of the capsular insertion intact. Sections were each cut along the cornal plane and along the sagittal plane at 200-300 p m thickness on a rotary milling saw, and then ground to a 20 p m thickness. The sections were stained with Cole's hematoxylin and eosin and examined via light and polarized light microscopy.Clinical Cases:Thirty shoulders of 29 patients with BLC lesions underwent arthroscopic debridement of the superior labrum.ResultsAnatomical Study: The LHB inserted directly to the superior glenoid and its attachment extended to the middle of the posterior glenoid. The LHB was firmly attached to the superior glenoid from the edge of the glenoid rim. The attachment was gradually loose toward the middle of the posterior glenoid. The LHB was attached to a large surface of the glenoid.Clinical Cases:All patients were able to return to competitive sports.DiscussionsBased on our anatomical study, the LHB has a larger attachment area on the glenoid than had been previously reported. Therefore, we believe debridement of the superior labrum for BLC lesions preserves the LHB functions.