[原著]野球選手の肩筋力と肩インピンジメントとの関連について
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概要
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The shoulder impingement syndrome may occur through the imbalance of the muscle strength around the shoulder of baseball players. Our previous study suggested that latissimus dorsi (LD), the back muscle which is the adductor and internal rotator of the shoulder, would possibly prevent shoulder impingement. The purposes of this study were to clarify the correlation between the muscle strength around shoulder and impingement signs in baseball players and to identify the influence of LD on impingement. This study was divided into three parts. First, the occurrence rate of impingement signs was examined in 480 high school baseball players. Second, the correlation between impingement sign and muscle activity recorded with surface electrodes was examined in 78 college baseball players. Finally, acromio-humeral interval (AHI) measured by radiogram was compared with muscle activity in 13 healthy volunteers. Result: 1. In high school baseball players, shoulder impingement sign was positive in 18.5 % of all the subjects. Among them, catchers showed the highest incidence of impingement sign (33.7%). Evaluation of back muscle strength revealed that catchers with positive impingement sign showed weaker back muscle strength than those with negativesign (p<0.05). 2. In college baseball players, back muscle strength was weaker in the positive group than the negative group (p<0.05). Also muscle activity recorded with surface electrodes was lower in the positive group than in the negative group. Maximum internal rotation strength of the shoulder at 90 degrees shoulder flexion was $33.65 \pm 7.17$ feet-lbs in the positive group and was $38.26 \pm 8.51$ feet-lbs in the negative group (p<0.05). Maximum muscle strength ratio of shoulder rotation at 90 degrees shoulder flexion was $60.00 \pm 15.30$ % in the positive group and $52.38 \pm 9.07$% in the negative group (p<0.05). Muscle activity of latissimus dorsi during maximum isometric internal rotation at 90 degrees shoulder flexion was lower in the positive group than in the negative group, 3. AHI at 90 degrees shoulder abduction and external rotation was $4.76 \pm 1.11$ mm at rest, $5.64 \pm 0.86$ mm during maximum isometric adduction, and $5.99 \pm 1.38$ mm during maximum isometric internal rotation. There were differences among them (p<0.05). Muscle activity of LD showed a positive correlation with AHI (p<0.05) during maximum isometric internal rotation. These results suggested that weak back muscles (especially LD strength) increased the incidence of impingement syndrome. LD pulled the humeral head downward during maximum isometric internal rotation and increased AHI. Strengthening of LD may prevent the occurrence of impingement syndrome.
- 琉球医学会,Ryukyu Medical Associationの論文
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