Association Between Acromiohumeral Distance, Shoulder Rotational Strength, And Range of Movements in University Basketball Players: A Cross-Sectional Study

Abstract

Objective: Limited information exists regarding the sports-related adaptations at the shoulder complex in university basketball players. Therefore, this study aimed to evaluate the shoulder rotational muscle strength, range of movements (ROM), and acromiohumeral distance (AHD) values to interpret side-to-side differences regarding injury risk factors in throwing and non-throwing shoulders of university basketball players. Materials and Methods: Twenty university basketball players (10 males, 10 females; age=20.2±1.8 years; body mass index=21.1±2.22 kg/m2) were included. AHD values, isometric and concentric strengths of shoulder external (ER) and internal rotation (IR), and shoulder ER, IR, and total rotational ROM were measured bilaterally. Results: AHD was greater on the throwing side at 0° (p<0.001) and 60° of shoulder abduction positions (p<0.001). However, throwing shoulders demonstrated more AHD reduction from 0° to 60° of shoulder abduction (p=0.01). We found greater isometric ER strength (p=0.006), ER/IR ratio (p=0.001), concentric ER strength (p<0.001), concentric ER/IR ratio (p<0.001), and ER ROM (p<0.001) in the throwing shoulders. Besides, AHD was correlated with isometric ER strength on the throwing side (p=0.012, r=0.552) and non-throwing side (p=0.041, r=0.461), also, isometric ER/IR strength ratio on the throwing side (p=0.017, r=0.526) and the non-throwing side (p=0.013, r=0.545). Conclusion: University basketball players demonstrated stronger ER muscle strength, higher ER/IR strength, increased ER ROM, and wider AHD values on the throwing shoulders. Moreover, greater ER muscle strength and ER/IR strength ratio were associated with greater AHD.

Keywords

• shoulder joint
• muscle strength
• subacromial space
• overhead athlete

Üniversite Basketbol Oyuncularında Akromiohumeral Mesafe, Omuz Rotasyonel Kas Kuvveti ve Eklem Hareket Açıklığı Arasındaki İlişki: Kesitsel Bir Çalişma

Abstract

Amaç: Literatürde, üniversite basketbol oyuncularında omuz kompleksindeki sporla ilgili adaptasyonlara ilişkin bilgiler sınırlıdır. Bu nedenle bu çalışmada üniversite basketbol oyuncularının baskın ve baskın olmayan omuzlarının rotasyonel kas kuvveti, eklem hareket açıklığı (EHA) akromiyohumeral mesafe (AHD) değerlerinin değerlendirilmesi ve yaralanma risk faktörleri açısından ekstremiteler arası farkların ortaya konması amaçlandı. Gereç ve Yöntem: Çalışmaya 20 üniversite basketbol oyuncusu (10 erkek, 10 kadın; yaş=20,2±1,8 yıl; vücut kitle indeksi=21,1±2,22 kg/m2) dahil edildi. AHM değerleri, omuz dış (ER) ve iç rotasyon (IR) izometrik ve konsantrik kas kuvvetleri ile omuz ER, IR ve toplam rotasyonel EHA’ları bilateral olarak ölçüldü. Bulgular: AHM değerleri baskın tarafta omuz 0° (p<0,001) ve 60° abduksiyon pozisyonlarında (p<0,001) daha fazlaydı. Ancak baskın omuzlarda, omuz abduksiyonu 0°'den 60°'ye ilerlendiğinde daha fazla AHM azalması görüldü (p=0,01). Baskın omuzda, izometrik ER kuvvetinin (p=0,006), ER/IR oranının (p=0,001), konsantrik ER kuvvetinin (p<0,001) ve ER/IR oranının (p<0,001) ve ER EHA’nın (p<0,001) daha fazla olduğunu bulduk. Ayrıca AHM değerleri, baskın taraftaki (p=0,012, r=0,552) ve baskın olmayan taraftaki (p=0,041, r=0,461) izometrik ER kuvvetiyle ve baskın taraf (p=0,017, r=0,526) ve baskın olmayan taraf (p=0,013, r=0,545) izometrik ER/IR kuvvet oranıyla da ilişkiliydi. Sonuç: Üniversite basketbol oyuncuları baskın taraflarında daha güçlü ER kas kuvveti, daha yüksek ER/IR kuvvet oranı, artmış ER EHA ve daha geniş AHM değerleri gösterdi. Ayrıca, daha yüksek ER kas kuvveti ve ER/IR kuvvet oranı daha yüksek AHM ile ilişkiliydi.

Keywords

• omuz eklemi
• kas kuvveti
• subakromiyal boşluk
• baş üstü sporcu

References

1. Aagaard, P., Simonsen, E., Trolle, M., Bangsbo, J., & Klausen, K. (1996). Specificity of training velocity and training load on gains in isokinetic knee joint strength. Acta Physiologica, 156(2), 123-129.
2. Alizadehkhaiyat, O., Hawkes, D. H., Kemp, G. J., & Frostick, S. P. (2015). Electromyographic analysis of shoulder girdle muscles during common internal rotation exercises. International Journal of Sports Physical Therapy, 10(5), 645.
3. Baltaci, G., & Tunay, V. B. (2004). Isokinetic performance at diagonal pattern and shoulder mobility in elite overhead athletes. Scand J Med Sci Sports, 14(4), 231-238.
4. Bonza, J. E., Fields, S. K., Yard, E. E., & Dawn Comstock, R. (2009). Shoulder injuries among United States high school athletes during the 2005–2006 and 2006–2007 school years. Journal of Athletic Training, 44(1), 76-83.
5. Borsa, P. A., Laudner, K. G., & Sauers, E. L. (2008). Mobility and stability adaptations in the shoulder of the overhead athlete. Sports medicine, 38(1), 17-36.
6. Burkhart, S. S. (1992). Fluoroscopic comparison of kinematic patterns in massive rotator cuff tears. A suspension bridge model. Clinical orthopaedics and related research(284), 144-152.
7. Burkhart, S. S., Morgan, C. D., & Kibler, W. B. (2003). The disabled throwing shoulder: spectrum of pathology Part I: pathoanatomy and biomechanics. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 19(4), 404-420.
8. Cholewinski, J. J., Kusz, D. J., Wojciechowski, P., Cielinski, L. S., & Zoladz, M. P. (2008a). Ultrasound measurement of rotator cuff thickness and acromio-humeral distance in the diagnosis of subacromial impingement syndrome of the shoulder. Knee Surg Sports Traumatol Arthrosc., 16(4), 408-414.

9. Cholewinski, J. J., Kusz, D. J., Wojciechowski, P., Cielinski, L. S., & Zoladz, M. P. (2008b). Ultrasound measurement of rotator cuff thickness and acromio-humeral distance in the diagnosis of subacromial impingement syndrome of the shoulder. Knee Surgery, Sports Traumatology, Arthroscopy, 16(4), 408-414.
10. Cools, A. M., Johansson, F. R., Borms, D., & Maenhout, A. (2015). Prevention of shoulder injuries in overhead athletes: a science-based approach. Brazilian journal of physical therapy, 19, 331-339.
11. de Oliveira, F. C. L., Bouyer, L. J., Ager, A. L., & Roy, J.-S. (2017). Electromyographic analysis of rotator cuff muscles in patients with rotator cuff tendinopathy: A systematic review. Journal of electromyography and Kinesiology, 35, 100-114.
12. Durall, C. J., Davies, G. J., Kernozek, T. W., Gibson, M. H., Fater, D. C., & Straker, J. S. (2001). The effects of training the humeral rotators on arm elevation in the scapular plane. Journal of Sport Rehabilitation, 10(2), 79-92.
13. Edouard, P., Samozino, P., Julia, M., Cervera, S. G., Vanbiervliet, W., Calmels, P., & Gremeaux, V. (2011). Reliability of isokinetic assessment of shoulder-rotator strength: a systematic review of the effect of position. Journal of Sport Rehabilitation, 20(3), 367-383.
14. Ellenbecker, T. S., & Davies, G. J. (2000). The application of isokinetics in testing and rehabilitation of the shoulder complex. Journal of athletic training, 35(3), 338.
15. Eraslan, L., Cools, A., Yar, O., Akkaya, S., & Duzgun, I. (2022). Acromiohumeral distance quantification during a variety of shoulder external and internal rotational exercises in recreationally overhead athletes. Research in Sports Medicine, 1-13.
16. Fieseler, G., Molitor, T., Irlenbusch, L., Delank, K.-S., Laudner, K. G., Hermassi, S., & Schwesig, R. (2015). Intrarater reliability of goniometry and hand-held dynamometry for shoulder and elbow examinations in female team handball athletes and asymptomatic volunteers. Archives of orthopaedic and trauma surgery, 135(12), 1719-1726.
17. Gouveia, K., Kay, J., Memon, M., Simunovic, N., & Ayeni, O. R. (2022). Glenohumeral internal rotation deficit in the adolescent overhead athlete: a systematic review and meta-analysis. Clinical journal of sport medicine, 32(5), 546-554.
18. Greenfield, B. H., Donatelli, R., Wooden, M. J., & Wilkes, J. (1990). Isokinetic evaluation of shoulder rotational strength between the plane of scapula and the frontal plane. The American journal of sports medicine, 18(2), 124-128.
19. Halder, A., Zhao, K. D., O'driscoll, S., Morrey, B., & An, K.-N. (2001). Dynamic contributions to superior shoulder stability. Journal of Orthopaedic Research, 19(2), 206-212.
20. Hinkle, D. E., Wiersma, W., & Jurs, S. G. (2003). Applied statistics for the behavioral sciences (Vol. 663). Houghton Mifflin Boston.
21. Kibler, W. B., Sciascia, A. D., & Grantham, W. J. (2023). The shoulder joint complex in the throwing motion. Journal of Shoulder and Elbow Surgery.
22. Kumar, P., Bradley, M., & Swinkels, A. (2010). Within-day and day-to-day intrarater reliability of ultrasonographic measurements of acromion-greater tuberosity distance in healthy people. Physiotherapy theory and practice, 26(5), 347-351.
23. Kumar, P., Chetwynd, J., Evans, A., Wardle, G., Crick, C., & Richardson, B. (2011). Interrater and intrarater reliability of ultrasonographic measurements of acromion-greater tuberosity distance in healthy people. Physiotherapy theory and practice, 27(2), 172-175.
24. Leong, H.-T., Tsui, S., Ying, M., Leung, V. Y.-f., & Fu, S. N. (2012). Ultrasound measurements on acromio-humeral distance and supraspinatus tendon thickness: test–retest reliability and correlations with shoulder rotational strengths. Journal of Science and Medicine in Sport, 15(4), 284-291.
25. Mackenzie, T., Herrington, L., Horsley, I., & Cools, A. (2015). Acromio-Humeral distance in athletes’ shoulders. Annals of Sports Medicine and Research, 2(7), 1042.
26. Maenhout, A., Van Eessel, V., Van Dyck, L., Vanraes, A., & Cools, A. (2012). Quantifying acromiohumeral distance in overhead athletes with glenohumeral internal rotation loss and the influence of a stretching program. The American journal of sports medicine, 40(9), 2105-2112.
27. Mayerhoefer, M. E., Breitenseher, M. J., Wurnig, C., & Roposch, A. (2009). Shoulder impingement: relationship of clinical symptoms and imaging criteria. Clinical Journal of Sport Medicine, 19(2), 83-89.
28. Michener, L. A., McClure, P. W., & Karduna, A. R. (2003). Anatomical and biomechanical mechanisms of subacromial impingement syndrome. Clinical Biomechanics, 18(5), 369-379.
29. Mondal, S., Nayek, B., & Chatterjee, K. (2016). A comparative study on strength, agility and dynamic balances between volleyball and basketball players. International Journal of Physiology, Nutrition and Physical Education, 1(2), 81-84.
30. Mukaka, M. M. (2012). A guide to appropriate use of correlation coefficient in medical research. Malawi medical journal, 24(3), 69-71.
31. Myers, J. B., Hwang, J.-H., Pasquale, M. R., Blackburn, J. T., & Lephart, S. M. (2009). Rotator cuff coactivation ratios in participants with subacromial impingement syndrome. Journal of Science and Medicine in Sport, 12(6), 603-608.
32. Navarro-Ledesma, S., & Luque-Suarez, A. (2018). Comparison of acromiohumeral distance in symptomatic and asymptomatic patient shoulders and those of healthy controls. Clinical Biomechanics, 53, 101-106.
33. Ohuchi, K., Kijima, H., Saito, H., Sugimura, Y., Yoshikawa, T., & Miyakoshi, N. (2023). Risk Factors for Glenohumeral Internal Rotation Deficit in Adolescent Athletes: A Comparison of Overhead Sports and Non-overhead Sports. Cureus, 15(1).
34. Owens, S., & Itamura, J. M. (2000). Differential diagnosis of shoulder injuries in sports. Operative Techniques in Sports Medicine, 8(4), 253-257.
35. Sauers, E. L., Huxel Bliven, K. C., Johnson, M. P., Falsone, S., & Walters, S. (2014). Hip and glenohumeral rotational range of motion in healthy professional baseball pitchers and position players. The American journal of sports medicine, 42(2), 430-436.
36. Schmidt, S. V., Engelhardt, J. A., Cools, A., Magnusson, S. P., & Couppé, C. (2021). Acromio-humeral distance is associated with shoulder external strength in national elite badminton players—A preliminary study. Sports, 9(4), 48.
37. Silva, R. T., Hartmann, L. G., de Souza Laurino, C. F., & Biló, J. R. (2010). Clinical and ultrasonographic correlation between scapular dyskinesia and subacromial space measurement among junior elite tennis players. British Journal of Sports Medicine, 44(6), 407-410.
38. Tooth, C., Gofflot, A., Schwartz, C., Croisier, J.-L., Beaudart, C., Bruyère, O., & Forthomme, B. (2020). Risk factors of overuse shoulder injuries in overhead athletes: a systematic review. Sports Health, 12(5), 478-487.