Amaç: Bu çalışma, elit adölesanlarda artistik jimnastiğin skapulotorasik eklem üzerine etkisini incelemek
amacıyla yapıldı.
Yöntemler: Çalışmaya 8-14 yaşları arasında, omuz bölgesi ve çevresinden herhangi bir teşhis/tedavi
almamış, en az 3 yıldır artistik cimnastik yapan 20 artistik cimnastikçi ve hiçbir spor branşında lisansı
bulunmayan 24 olgu katıldı. Çalışmaya katılan tüm olgulara demografik bilgileri ve spor özgeçmişleri
alındıktan sonra skapular kassal endurans testi, gözlemsel skapular diskinezi testi, lateral skapular kayma
testi, protraksiyon derecesi ve posterior kapsül gerginliği değerlendirmeleri uygulandı.
Sonuçlar: Cimnastik grubunda spor yılı ile skapular kassal endurans arasında anlamlı bir ilişki bulunurken
(p<0.05), spor yılı ile posterior kapsül gerginliği ve protraksiyon derecesi arasında anlamlı bir ilişki
bulunamadı (p>0.05). Gruplar arasında skapular kassal endurans ve skapular diskinezide anlamlı bir
fark bulunmazken (p>0.05), skapular kassal endurans değerleri erkeklerde cimnastikçiler lehine anlamlı
olarak farklı bulundu (p<0.05). Skapular diskinezi ise kadınlarda kontrol grubu lehine istatistiksel olarak
anlamlıydı (p<0.05). Gruplar arası karşılaştırmada protraksiyon derecesi, non-dominant tarafta; posterior
kapsül gerginliği ise hem dominant hem de non-dominant tarafta cimnastik grubu lehine anlamlı olarak
farklı bulundu (p<0.05).
Tartışma: Artistik cimnastik sporunun skapular kaslara olumlu etki ettiği görülmüştür ancak sporcu
olmayan adölesanlarla farkın bulunmayışı ve ileride spora bağlı gelişebilecek skapula ve omuz kuşağına
yönelik postüral adaptasyonlar da düşünüldüğünde sporcuların skapula stabilizasyon eğitimini de içeren
antrenman programlarına alınması gerekliliği gösterilmiştir. İlerideki çalışmalarda artrokinematik
değişikleri detaylı inceleyebilmek için hareket analiz sistemleri kullanılmalıdır.
1. Türkiye Cimnastik Federasyonu [home page on internet]. [up- dated 2011 Dec 14; cited 2014 Feb 22]. Available from: http:// www.tcf.gov.tr/ckfinder/userfiles/files/WAG-HareketListesi.pdf
2. Singh S, Smith GA, Fields SK, McKenzie LB. Gymnastics-related injuries to children treated in emergency departments in the United States, 1990-2005. Pediatrics. 2008;121(4):954-60.
3. Jemni M. The Science of gymnastics. 1st ed. London and New York: Routledge Taylor and Francis Group;2011.
4. Güven N. Okul öncesi ve ilköğretimde beden eğitimi. 4. baskı. Ankara: Kök Yayıncılık;2005.
5. Caine DJ, Nassar L. Gymnastics injuries. Med Sport Sci. 2005;48:18-58.
6. Cools A, van De Lanotte L. Descriptive profile of shoulder and scapular ROM and strength measurements in junior recreational and elite gymnasts. Br J Sports Med. 2014;48(7):581.
7. DiFiori JP, Puffer JC, Aish B, Dorey F. Wrist pain in young gymnasts: frequency and effects upon training over 1 year. Clin J Sport Med. 2002;12(6):348-53.
8. DiFiori JP, Puffer JC, Mandelbaum BR, Dorey F. Distal radial growth plate injury and positive ulnar variance in nonelite gymnasts. Am J Sports Med. 1997;25(6):763-8.
9. Borromeo R, Burns JW, Hammons S, Prevo K, van Dover D, Zawic- ki P. Shoulder gridle. In: Lippert L, editor. Clinical kinesiology and anatomy. 5th. ed. Philadelphia: FA Davis, 2006; p.115-30.
10. Jemni M. Physiology of gymnastics. In: Jemni M, editor. The science of gymnastics. 1st ed. New York: Routledge, 2011; p.1- 55.
12. Halliday S. Upper Extremity vertical ground reaction forces du- ring the back handspring skill in gymnastics: A comparison of various braced vs. unbraced techniques. Michigan. Eastern Michigan University;2013.
13. Kibler WB, McMullen J. Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg. 2003;11(2):142-51.
14. Cools AM, Geerooms E, Van den Berghe DF, Cambier DC, Witvrouw EE. Isokinetic scapular muscle performance in young elite gymnasts. J Athl Train. 2007;42(4):458-63.
15. Eraslan U, Gelecek N, Genc A. Effect of scapular muscle endurance on chronic shoulder pain in textile workers. J Back Musculoskelet Rehabil. 2013;26(1):25-31.
16. Edmondston SJ, Wallumrod ME, Macleid F, Kvamme LS, Joebqes S, Brabham GC. Reliability of isometric muscle endurance tests in subjects with postural neck pain. J Manipulative Physiol Ther. 2008;31(5):348-54.
17. Kibler WB, Uhl TL, Maddux JW, Brooks PV, Zeller B, McMullen J. Qualitative clinical evaluation of scapular dysfunction: a reliabi- lity study. J Shoulder Elbow Surg. 2002;11(6):550-6.
18. Uhl TL, Kibler WB, Gecewich B, Tripp BL. Evaluation of clini- cal assessment methods for scapular dyskinesis. Arthroscopy. 2009;25(11):1240-8.
19. Odom CJ, Taylor AB, Hurd CE, Denegar CR. Measurement of sca- pular asymetry and assessment of shoulder dysfunction using the Lateral Scapular Slide Test: a reliability and validity study. Phys Ther. 2001;81(2):799-809.
20. Kibler WB. The role of the scapula in athletic shoulder function. Am J Sports Med. 1998;26(2):325-37.
21. Myers JB, Oyama S, Wassinger CA, Ricci RD, Abt JP, Conley KM, et al. Reliability, precision, accuracy, and validity of posteri- or shoulder tightness assessment in overhead athletes. Am J Sports Med. 2007;35(11):1922-30.
22. Otman S, Köse N. Tedavi hareketlerinde temel değerlendirme prensipleri. 4. Baskı. Ankara: Yücel Ofset Matbaacılık; 2008.
23. Struyf F, Nijs J, De Coninck K, Giunta M, Mottram S, Meeusen R. Clinical assessment of scapular positioning in musicians: an intertester reliability study. J Athl Train. 2009;44(5):519-26.
24. Day JM. Scapular muscle assessment in patients with lateral epicondylalgia. Kentucky: University of Kentucky; 2013.
25. Fujioka H, Nishikawa, T, Koyama S, Yamashita M, Takagi Y, Oi T, et al. Stress fractures of bilateral clavicles in an adolescent gymnast. J Shoulder Elbow Surg 2014;23(4):88-90.
26. Myers JB, Oyama S, Hibberd EE. Scapular dysfunction in high school baseball players sustaining throwing-related upper extremity injury: a prospective study. J Shoulder Elbow Surg. 2013;22(9):1154-59.
THE INVESTIGATION OF THE EFFECT OF ARTISTIC GYMNASTICS ON SCAPULOTHORACIC JOINT IN ELITE ADOLESCENTS
Purpose: This study was done to investigate the effect of artistic gymnastics on scapulothoracic joint in elite adolescent artistic gymnasts.
Methods: Twenty elite adolescent artistic gymnasts between 8-14 ages, who had no diagnoses/ treatment from the shoulder region, and have been doing artistic gymnastics for at least 3 years; 24 cases
who have no license in any sports included into this study. Scapular muscle endurance test, observational
scapular dyskinesia test, lateral scapular slide test, protraction degree and tightness of posterior capsule measurements were done after obtaining their demographic information and sports history.
Results: While there was a significant relation between sports year and scapular muscle endurance in gymnasts (p<0.05), no relation was found between sports year and posterior capsule tightness and protraction degree (p>0.05). While there was no significant difference between groups for scapular muscle
endurance and scapular dyskinesia (p>0.05), scapular muscle endurance values were significantly different in male gymnasts (p<0.05). Scapular dyskinesia on the other hand, was statistically significant
in female controls (p<0.05). When we compare two groups; protraction degree in non-dominant side,
posterior capsule tightness in both sides were found significantly different in favor of gymnasts (p<0.05).
Discussion: We found artistic gymnastics affected scapular muscles however; the results indicated no
difference between groups, besides the possible postural adaptations on scapula and shoulder girdle depend upon gymnastics showed the essentiality of special exercises for this region in training programs.
In future studies, motion analysis systems should be used for detailed investigation of arthrokinematic
changes.
1. Türkiye Cimnastik Federasyonu [home page on internet]. [up- dated 2011 Dec 14; cited 2014 Feb 22]. Available from: http:// www.tcf.gov.tr/ckfinder/userfiles/files/WAG-HareketListesi.pdf
2. Singh S, Smith GA, Fields SK, McKenzie LB. Gymnastics-related injuries to children treated in emergency departments in the United States, 1990-2005. Pediatrics. 2008;121(4):954-60.
3. Jemni M. The Science of gymnastics. 1st ed. London and New York: Routledge Taylor and Francis Group;2011.
4. Güven N. Okul öncesi ve ilköğretimde beden eğitimi. 4. baskı. Ankara: Kök Yayıncılık;2005.
5. Caine DJ, Nassar L. Gymnastics injuries. Med Sport Sci. 2005;48:18-58.
6. Cools A, van De Lanotte L. Descriptive profile of shoulder and scapular ROM and strength measurements in junior recreational and elite gymnasts. Br J Sports Med. 2014;48(7):581.
7. DiFiori JP, Puffer JC, Aish B, Dorey F. Wrist pain in young gymnasts: frequency and effects upon training over 1 year. Clin J Sport Med. 2002;12(6):348-53.
8. DiFiori JP, Puffer JC, Mandelbaum BR, Dorey F. Distal radial growth plate injury and positive ulnar variance in nonelite gymnasts. Am J Sports Med. 1997;25(6):763-8.
9. Borromeo R, Burns JW, Hammons S, Prevo K, van Dover D, Zawic- ki P. Shoulder gridle. In: Lippert L, editor. Clinical kinesiology and anatomy. 5th. ed. Philadelphia: FA Davis, 2006; p.115-30.
10. Jemni M. Physiology of gymnastics. In: Jemni M, editor. The science of gymnastics. 1st ed. New York: Routledge, 2011; p.1- 55.
12. Halliday S. Upper Extremity vertical ground reaction forces du- ring the back handspring skill in gymnastics: A comparison of various braced vs. unbraced techniques. Michigan. Eastern Michigan University;2013.
13. Kibler WB, McMullen J. Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg. 2003;11(2):142-51.
14. Cools AM, Geerooms E, Van den Berghe DF, Cambier DC, Witvrouw EE. Isokinetic scapular muscle performance in young elite gymnasts. J Athl Train. 2007;42(4):458-63.
15. Eraslan U, Gelecek N, Genc A. Effect of scapular muscle endurance on chronic shoulder pain in textile workers. J Back Musculoskelet Rehabil. 2013;26(1):25-31.
16. Edmondston SJ, Wallumrod ME, Macleid F, Kvamme LS, Joebqes S, Brabham GC. Reliability of isometric muscle endurance tests in subjects with postural neck pain. J Manipulative Physiol Ther. 2008;31(5):348-54.
17. Kibler WB, Uhl TL, Maddux JW, Brooks PV, Zeller B, McMullen J. Qualitative clinical evaluation of scapular dysfunction: a reliabi- lity study. J Shoulder Elbow Surg. 2002;11(6):550-6.
18. Uhl TL, Kibler WB, Gecewich B, Tripp BL. Evaluation of clini- cal assessment methods for scapular dyskinesis. Arthroscopy. 2009;25(11):1240-8.
19. Odom CJ, Taylor AB, Hurd CE, Denegar CR. Measurement of sca- pular asymetry and assessment of shoulder dysfunction using the Lateral Scapular Slide Test: a reliability and validity study. Phys Ther. 2001;81(2):799-809.
20. Kibler WB. The role of the scapula in athletic shoulder function. Am J Sports Med. 1998;26(2):325-37.
21. Myers JB, Oyama S, Wassinger CA, Ricci RD, Abt JP, Conley KM, et al. Reliability, precision, accuracy, and validity of posteri- or shoulder tightness assessment in overhead athletes. Am J Sports Med. 2007;35(11):1922-30.
22. Otman S, Köse N. Tedavi hareketlerinde temel değerlendirme prensipleri. 4. Baskı. Ankara: Yücel Ofset Matbaacılık; 2008.
23. Struyf F, Nijs J, De Coninck K, Giunta M, Mottram S, Meeusen R. Clinical assessment of scapular positioning in musicians: an intertester reliability study. J Athl Train. 2009;44(5):519-26.
24. Day JM. Scapular muscle assessment in patients with lateral epicondylalgia. Kentucky: University of Kentucky; 2013.
25. Fujioka H, Nishikawa, T, Koyama S, Yamashita M, Takagi Y, Oi T, et al. Stress fractures of bilateral clavicles in an adolescent gymnast. J Shoulder Elbow Surg 2014;23(4):88-90.
26. Myers JB, Oyama S, Hibberd EE. Scapular dysfunction in high school baseball players sustaining throwing-related upper extremity injury: a prospective study. J Shoulder Elbow Surg. 2013;22(9):1154-59.