Assessment of Shoulder Flexibility and Strength in Collegiate Baseball Players

背景:棒球技球動作是在一個外展過頭部(overhead position)且肩關節角度極度外轉的姿勢下,作出高速爆發的技術性動作,軟組織須承受相當大的力量,因此對棒球選手來說,大多慢性與過度使用所造成的肌肉骨酪系統症狀來自投球動作。本研究擬透過暑訓前後之兩次追蹤檢查,對棒球隊員進行肩關節肌力與關節活動度檢查的記錄,配合運動員的主述,核磁共振掃瞄與醫師之理學檢查,研究肩關節運動傷害之發生與人體測量學資料間之相關性。實施方法:選定某大專院校之棒球校隊,經由全隊同意,進行本研究計劃。在校隊暑訓前收集選手之基本資料,再於暑訓結束後做進行第二次測試,比較兩次測試之差異。測試內容包括選手基本資料問卷調查、肩關節理學檢查、肩關節活動度測量與肩部徒手肌力測試與肩關節核磁共振掃瞄攝影。結果:本研究結果發現暑訓前後投球側與非投球側的外轉與內轉角度值有顯著差異,投球側外轉角度值明顯大於非投球側,內轉角度值則是非投球側明顯大於投球側。在暑訓後投球側與非投球側則只有內轉角度值有明顯差異。暑訓前後肌力比較發現暑訓後肩關節肌力並無明顯差異而且只有二頭肌與前三角肌比暑訓前略為增強但是未達統計上之意義。在投球側的後三角肌與脊下肌之肌力卻出現暑訓後反而明顯有降的現象，非投球側的脊下肌也有相同情況。共有15名接受MRI檢查其中有9 位核磁共振有病理變化的運動員中只有兩名主述有肩關節疼痛,其它7名運動員主觀上均無肩關節疼痛之問題。若以核磁掃瞄有病理變化與沒病理變化分兩組作肌力測試之結果分析,兩組間並無顯著差異存在。結論:本研究發現經過暑訓前後確實在肩關節活動度與肌力方面有明顯改變,但是現階段的追蹤研究中並無發現這些改變與運動傷害或者是肩關前疼痛有鄉關性存在,未來應該是需要更畏的時間追蹤與觀察。

關鍵字

肩關節；運動傷害；肌力,關節活動度； MRI

並列摘要

Background and purposes: The incidence of shoulder injuries remains high in baseball players, because the act of throwing a baseball places unique stress on the glenohumeral joint and its surrounding structures. This study was designed to observe sports injuries to the shoulder in a group of collegiate baseball players with the intention to determine risk factors for injury. Methods：One college baseball team was included. Baseline data were documented, and assessments of members’ shoulders were performed before and after summer training. These included a shoulder injury questionnaire, special physical tests Speed test, Neer’s impingement, Hawkins-Kennedy test, 3.nd the empty can test), manual muscle testing, range of motion (ROM), and MRI study of the shoulders. Results: Sixteen baseball players completed these assessments. After summer training, 3 of them complained of shoulder pain during the training course, 7 of them revealed positive findings on the special shoulder tests, and 9 of them were noted to have pathological findings on the shoulder MRI examinations. There were no significant differences in the muscle strength and ROM of the shoulder between the injured and uninjured groups. After intensive training, an interesting finding in the muscle strength was observed: except for the biceps, the strength of all the muscles of the shoulder girdle decreased. Significant decreases in muscle strength were observed in the infraspinatus and posterior deltoid muscles. The shoulder ROM improved after summer training, but the internal rotation of the throwing shoulder was still significantly less than that of the non-throwing side. Conclusions: Shoulder injuries were observed in this group of collegiate baseball players. No significant relationship was observed between shoulder injury and muscle strength, or between shoulder injury and flexibility. Further longer follow up observations are needed to determine the risk factors for shoulder injuries among baseball players.

並列關鍵字

shoulder injury ； baseball ； shoulder flexibility ； muscle strength ； MRI

國際替代計量

Assessment of Shoulder Flexibility and Strength in Collegiate Baseball Players

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