Date of Award

1994

Document Type

Scholarly Project

Degree Name

Master of Physical Therapy (MPT)

Department

Physical Therapy

First Advisor

Beverly Johnson

Keywords

Shoulder -- injuries; Physical Therapy

Abstract

An increase interest of the shoulder complex has led to additional knowledge through research and enhancement of rehabilitation for various shoulder disorders. Shoulder injuries are common for overhead sporting activities, such as pitching. The pitching mechanism combines a high level of neuromuscular coordination between the glenohumeral and scapulothoracic muscles. The intricate balance and timing of these muscles is necessary to allow full mobility and to maintain the dynamic stability throughout the entire throwing motion. Any deficiency in muscular strength or timing can affect shoulder function and potentially cause shoulder instability.

Rehabilitation and nonoperative management of shoulder pain due to instability currently concentrates on flexibility, dynamic stabilization of the glenohumeral joint, and strengthening of the muscles involved in pitching. Dynamic stability is accomplished by proprioceptive training and scapular musculature strengthening. Electromyographic (EMG) studies have analyzed the muscle activation patterns during a normal throwing motion. This EMG information enables therapists to identify when muscle imbalances exist and to extrapolate the various mechanisms of injury during each stage of pitching. EMG studies have also shown which exercises are efficient in training the muscles around the shoulder complex.

The purpose of this independent study is to review the pertinent anatomy and biomechanics of the shoulder, to examine mechanisms of instability syndromes, and to develop a rehabilitation program for the throwing athlete that ensures flexibility and dynamic muscular balance around the shoulder.

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