Altered Cervical Spine Position Results in Decreased Eccentric Shoulder Rotation Strength

Abstract

Overhead athletes require strenuous shoulder activity in nonneutral cervical spine positions to eccentrically decelerate the throwing/striking arm following ball release/contact. We therefore aimed to compare eccentric shoulder rotation strength through a 90° arc between neutral and rotated positions. Fifty-two participants (19 M, 34 F 170±10 cm; 73±18 kg, 21.9±2.9 years) without shoulder or cervical spine pathology participated. Isokinetic eccentric shoulder rotation strength was measured through a 90° arc with the shoulder elevated 90° in frontal plane (frontal plane), and 45° anterior to the frontal plane (scapular plane) in neutral and rotated cervical spine positions. Cervical spine position was obtained by instructing participants to maximally rotate their respective side. Frontal plane eccentric external rotated strength differed between neutral and contralaterally positions in the first 10° of the motion, near forearm vertical (p+=+0.029). Internal rotation strength differed between neutral and contralaterally rotated positions from 55–60° external rotation (p+=+0.004). Scapular plane eccentric external rotation differed between cervical positions between 21–67° shoulder external rotation (p<0.001). Scapular plane internal rotation strength differed between cervical positions between 22–60° shoulder external rotation (p<0.001). In populations requiring strenuous use of their shoulders in altered cervical spine positions, sports medicine clinicians should consider including strength testing that reflects the functional positions of their patients during an orthopedic examination.

Keywords

dynamometry - neck - spinal posture - strength testing

Publication History

Received: 01 December 2023

Accepted: 04 March 2024

Accepted Manuscript online:
04 March 2024

Article published online:
02 April 2024

• References

• 1 Gary M. Franklin LG, Hal Stockbridge, Robert Mootz, Teresa Cooper, Bintu Marong. Medical Treatment Guideline for Shoulder Diagnosis and Treatment –updated May 2018. Washington state department of labor & industries, 2018
• 2 Byram IR, Bushnell BD, Dugger K. et al. Preseason shoulder strength measurements in professional baseball pitchers: Identifying players at risk for injury. Am J Sports Med 2010; 38: 1375-1382
• 3 Giordano KA, Wasserberger KW, Oliver GD. Altered Cervical Spine Position Results in Decreased Shoulder Rotation Strength. Clin Orthop Relat Res 2022; 10: 1097
• 4 Hill AV. The heat of shortening and the dynamic constants of muscle. Proceedings of the Royal Society of London Series B (Biological sciences) 1938; 126: 136-195 DOI: 10.1098/rspb.1938.0050.
• 5 Hill AV. First and last experiments in muscle mechanics. Cambridge University Press; 1970
• 6 Butler D, Gifford L. The concept of adverse mechanical tension in the nervous system part 1: Testing for “dural tension”. Physiother 1989; 75: 622-629
• 7 Butler D, Gifford L. The concept of adverse mechanical tension in the nervous system part 2: Examination and treatment. Physiother 1989; 75: 629-636
• 8 Cook C, Hegedus E, Showalter C. et al. Coupling behavior of the cervical spine: a systematic review of the literature. Journal of manipulative and physiological therapeutics 2006; 29: 570-575
• 9 Roy J-S, MacDermid JC, Orton B. et al. The concurrent validity of a hand-held versus a stationary dynamometer in testing isometric shoulder strength. J Hand Ther 2009; 22: 320-327
• 10 DiGiovine NM, Jobe FW, Pink M. et al. An electromyographic analysis of the upper extremity in pitching. J Shoulder Elbow Surg 1992; 1: 15-25
• 11 Tousignant M, Smeesters C, Breton A-M. et al. Criterion validity study of the cervical range of motion (CROM) device for rotational range of motion on healthy adults. J Orthop Sports Phys Ther 2006; 36: 242-248
• 12 Edouard P, Samozino P, Julia M. et al. Reliability of isokinetic assessment of shoulder-rotator strength: A systematic review of the effect of position. J Sport Rehabil 2011; 20: 367-383
• 13 Mandalidis D, Donne B, O'Regan M. et al. Reliability of isokinetic internal and external rotation of the shoulder in the scapular plane. Isokinet Exerc Sci 2001; 9: 65-72
• 14 Cools A, Declercq G, Cambier D. et al. Trapezius activity and intramuscular balance during isokinetic exercise in overhead athletes with impingement symptoms. Scand J Med Sci Sports 2007; 17: 25-33
• 15 Vanderstukken F, Jansen N, Mertens T. et al. Elite male field hockey players have symmetric isokinetic glenohumeral strength profiles, but show asymmetry in scapular muscle strength. J Sports Sci 2019; 37: 484-491
• 16 Giordano KA, Cich M, Oliver GD. Length-Tension Differences Between Concentric and Eccentric Shoulder Rotation Strength. J Strength Cond Res 2022; 10: 1519
• 17 Ling W, Chen FC, McDonough AL. Evaluation of the cushion setting on performance of a Biodex II dynamometer. Arch Phys Med Rehabil 1999; 80: 350-354
• 18 Friston KJ, Holmes AP, Poline J. et al. Analysis of fMRI time-series revisited. Neuroimage 1995; 2: 45-53
• 19 Pataky TC. Generalized n-dimensional biomechanical field analysis using statistical parametric mapping. J Biomech 2010; 43: 1976-1982
• 20 Pataky TC, Robinson MA, Vanrenterghem J. Vector field statistical analysis of kinematic and force trajectories. J Biomech 2013; 46: 2394-2401
• 21 Benjamini Y, Hochberg Y. Controlling the false discovery rate: A practical and powerful approach to multiple testing. Journal of the Royal Statistical Society: Series B (Methodological) 1995; 57: 289-300
• 22 Nichols T, Hayasaka S. Controlling the familywise error rate in functional neuroimaging: A comparative review. Stat Methods Med Res 2003; 12: 419-446
• 23 Wilson GJ, Wood GA, Elliott BC. Optimal stiffness of series elastic component in a stretch-shorten cycle activity. J Appl Physiol 1991; 70: 825-833
• 24 Fleisig GS, Barrentine SW, Escamilla RF. et al. Biomechanics of overhand throwing with implications for injuries. Sports Med 1996; 21: 421-437
• 25 Park J-Y, Lee J-H, Oh K-S. et al. Return to play after arthroscopic treatment for shoulder instability in elite and professional baseball players. J Shoulder Elbow Surg 2019; 28: 77-81
• 26 Sangwan S, Green RA, Taylor NF. Stabilizing characteristics of rotator cuff muscles: a systematic review. Disabil Rehabil 2015; 37: 1033-1043
• 27 Clabbers KM, Kelly JD, Bader D. et al. Effect of posterior capsule tightness on glenohumeral translation in the late-cocking phase of pitching. J Sport Rehab 2007; 16: 41-49
• 28 Wright RW, Paletta GA. Prevalence of the Bennett lesion of the shoulder in major league pitchers. Am J Sports Med 2004; 32: 121-124
• 29 Del Vecchio F, Farias C, De Leon R. et al. Injuries in martial arts and combat sports: prevalence, characteristics and mechanisms. Sci Sports 2018; 33: 158-163
• 30 Oatis CA. Kinesiology: The mechanics and pathomechanics of human movement. Philadelphia: Wolters Kluwer,; 2017
• 31 Thigpen CA, Padua DA, Michener LA. et al. Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. J Electromyogr Kinesiol 2010; 20: 701-709