2nd. Comparison of Self-stretch Methods for Secondary Internal Rotation Limitation in Injured Throwing Shoulders: Evaluation of the Direct Effect

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1 原著 2nd Comparison of Self-stretch Methods for Secondary Internal Rotation Limitation in Injured Throwing Shoulders: Evaluation of the Direct Effect 1,2) 1) 1) 3) 3) KENTARO KAWAI, RPT, MS 1,2), HIROKI FUNASAKI, MD, PhD 1), HIROTERU HAYASHI, MD 1), HARUYASU KATO, MD, PhD 3), HIDEO NUMAZAWA 3) 1) Department of Sports and Wellness Clinic, Jikei University School of Medicine: Nishishinbashi Minato-ku, Tokyo , Japan TEL kentaro@jikei.ac.jp 2) Graduate School of Community and Human Services, Rikkyo University, Doctoral Course 3) Graduate School of Community and Human Services, Rikkyo University Rigakuryoho Kagaku 31(1): 13 17, Submitted Jul. 27, Accepted Aug. 21, ABSTRACT: [Purpose] To examine and compare the effectiveness of three self-stretch methods for secondary internal rotation limitation in injured throwing shoulders. [Subjects] Forty-eight baseball players with injured throwing shoulders. [Methods] First, inability to perform the APS, CB, and IRS stretch methods due to pain were compared among the subjects. Then, the 28 cases who could perform all of the stretch methods were divided into 3 groups, and excluding the effect of the retroversion angle, the secondary internal rotation angle was measured before and after stretch performance and compared among the groups. [Results] The inability to perform stretching due to pain was significantly the lowest for the APS method. There were no significant differences in the secondary internal rotation angle among the groups before stretching, but after stretching, those of the groups performing the APS and CB methods were significantly larger than that of the IRS method group. [Conclusion] The results suggest that the APS method is the most effective self-stretch method for injured throwing shoulders. Key words: disabled throwing shoulder, internal rotation limitation of the shoulder, self-stretch 要旨 : 2nd 3 48 APS CB IRS nd APS 2nd 3 APS CB IRS APS キーワード : 1) : TEL ) 3)

2 I. はじめに nd II. 対象と方法 2nd 2nd 1,2) 1 3,4) 5,6) 48 7) 2nd tightness cm PST 8,9) cm kg 64 7) 2nd 86 kg nd PST PST 10) 2 PST All-fours posterior stretch APS 11,12) PST Cross-body stretch CB Internal rotation stretch IRS 3 APS 13) PST 10 cm 14) Johansen 1 CB 90 stretch 15) F-K stretch 16) 3 2 IRS Cross-body stretch CB 17) Internal 90 rotation stretch IRS 18) 90 PST All-fours 30 posterior stretch APS 19,20) CB 28 IRS PST 3 1 APS 10 CB 9 IRS 9 PST nd nd 3 APS CB IRS

3 2nd 15 図 1 APS 10 cm 図 3 IRS 図 4 図 2 CB 90 3 χ 2 paired t-test 3 Tukey-Kramer 5 Ito 21) 2nd 1 FAZON M FUJIFILM Hz 3) 6 1 3) 7) cm kg intraclass correlation coefficient: ICC ICC p<0.01 III. 結果 APS CB IRS

16 31 1 図 5 APS p<0.05 1 28 APS 10 CB 9 IRS 9 APS 18 CB 16 IRS 7 p<0.05 3 3 APS CB IRS p<0.05 2 IV.

IRS Hawkins test 20) PST 20) PST APS APS CB PST IRS Hawkins test 20) CB Laudner 18) 33 表 1 3 APS 2 4.2% CB 11 22.

4 図 5 APS p< APS 10 CB 9 IRS 9 APS 18 CB 16 IRS 7 p< APS CB IRS p< IV. 考 2nd 3 APS CB IRS APS CB IRS 22) 14 APS IRS IRS 12 APS 45 察図 6 APS APS 56 20) APS IRS 2 2nd CB IRS PST 17,18) PST 20) IRS Hawkins test 20) PST 20) PST APS APS CB PST IRS Hawkins test 20) CB Laudner 18) 33 表 1 3 APS 2 4.2% CB % IRS % n=48 p<0.05 χ 2 表 2 APS n= CB n= IRS n= n=28 p<0.05 paired t-test p<0.05 Tukey-Kramer

5 2nd 17 IRS Tyler 23) 22 PST IRS 2nd APS IRS 20) IRS APS APS 引用文献 1) Bigliani LU, Codd TP, Connor PM, et al.: Shoulder motion and laxity in the professional baseball player. Am J Sports Med, 1997, 25(5): ) Crockett HC, Gross LB, Wilk KE, et al.: Osseous adaptation and range of motion at the glenohumeral joint in professional baseball pitchers. Am J Sports Med, 2002, 30(1): ) , 55(1): ) Cowgill LW: Humeral torsion revisited: a functional and ontogenetic model for populational variation. Am J Phys Anthropol, 2007, 134(4): ) Tyler TF, Roy T, Nicholas SJ, et al.: Reliability and validity of a new method of measuring posterior shoulder tightness. J Orthp Sports Phys, 1999, 29(5): ) 2007, 20(4): ), 2014, 29(3): ), 2003, 21: ) 2002, 19: ) Myers JB, Oyama S, Wassinger CA, et al.: Reliability, precision, accuracy, and validity of posterior shoulder tightness assessment in overhead athletes. Am J Sports Med, 2007, 35(11): ) Pappas AM, Zawacki RM, Sullivan TJ: Biomechanics of baseball pitching. A preliminary report. Am J Sports, 1985, 13(4): ) Fleisig GS, Andrews JR, Dillman CJ, et al.: Kinetics of baseball pitching with implications about injury mechanisms. Am J Sports Med, 1995, 23(2): ) Burkhart SS, Morgan CD: The peel-back mechanism: its role in producing and extending posterior type II SLAP lesions and its effect on SLAP repair rehabilitation. Arthroscopy, 1998, 14(6): ) Conroy DE, Hayes KW: The effect of joint mobilization as a component of comprehensive treatment for primary shoulder impingement syndrome. J Orthop Sports Phys Ther, 1998, 28(1): ) modified Johansen stretch 2008, 20: ) F-K 2012, 36(2): ) McClure P, Balaicuis J, Heiland D: A randomized controlled comparison of stretching procedures for posterior shoulder tightness. J Orthop Sports Phys Ther, 2007, 37(3): ) Laudner KG, Sipes RC, Wilson JT: The acute effects of sleeper stretches on shoulder range of motion. J Athl Train, 2008, 43(4): ), 2003, 46(10): ) 2012, 20(1): ) Ito N, Eto M, Maeda K, et al.: Ultrasonographic measurement of humeral torsion. J Shoulder Elbow Surg, 1995, 4(3): ) 2008, 35(2): ) Tyler TF, Nicholas SJ, Lee SJ, et al.: Correction of posterior shoulder tightness is associated with symptom resolution in patients with internal impingement. Am J Sports Med, 2010, 38(1):

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