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      Unilateral and bilateral training competitive archers differ in some potentially unhealthy neck-shoulder region movement behaviour characteristics

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          Abstract

          Background

          Excessive unilateral joint loads may lead to overuse disorders. Bilateral training in archery is only performed as a supportive coordination training and as a variation of typical exercise. However, a series of studies demonstrated a crossover transfer of training-induced motor skills to the contralateral side, especially in case of mainly unilateral skills. We compared the cervical spine and shoulder kinematics of unilateral and bilateral training archers.

          Methods

          In this cross-sectional study, 25 (5 females, 48 ± 14 years) bilaterally training and 50 age-, sex- and level-matched (1:2; 47.3 ± 13.9 years) unilaterally training competitive archers were included. Cervical range of motion (RoM, all planes) and glenohumeral rotation were assessed with an ultrasound-based 3D motion analysis system. Upward rotation of the scapula during abduction and elevation of the arm were measured by means of a digital inclinometer and active shoulder mobility by means of an electronic caliper. All outcomes were compared between groups (unilaterally vs. bilaterally) and sides (pull-hand- vs. bow-hand-side).

          Results

          Unilateral and bilateral archers showed no between group and no side-to-side-differences in either of the movement direction of the cervical spine. The unilateral archers had higher pull-arm-side total glenohumeral rotation than the bilateral archers (mean, 95% CI), (148°, 144–152° vs. 140°, 135°-145°). In particular, internal rotation (61°, 58–65° vs. 56°, 51–61°) and more upward rotation of the scapula at 45 degrees (12°, 11–14° vs. 8°, 6–10°), 90 degrees (34°, 31–36° vs. 28°, 24–32°), 135 degrees (56°, 53–59° vs. 49°, 46–53°), and maximal (68°, 65–70° vs. 62°, 59–65°) arm abduction differed. The bow- and pull-arm of the unilateral, but not of the bilateral archers, differed in the active mobility of the shoulder (22 cm, 20–24 cm vs. 18 cm, 16–20 cm).

          Conclusions

          Unilaterally training archers display no unphysiologic movement behaviour of the cervical spine, but show distinct shoulder asymmetris in the bow- and pull-arm-side when compared to bilateral archers in glenohumeral rotation, scapula rotation during arm abduction, and active mobility of the shoulder. These asymmetries in may exceed physiological performance-enhancing degrees. Bilateral training may seems appropriate in archery to prevent asymmetries.

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          Most cited references22

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          The association of scapular kinematics and glenohumeral joint pathologies.

          There is a growing body of literature associating abnormal scapular positions and motions, and, to a lesser degree, clavicular kinematics with a variety of shoulder pathologies. The purpose of this manuscript is to (1) review the normal kinematics of the scapula and clavicle during arm elevation, (2) review the evidence for abnormal scapular and clavicular kinematics in glenohumeral joint pathologies, (3) review potential biomechanical implications and mechanisms of these kinematic alterations, and (4) relate these biomechanical factors to considerations in the patient management process for these disorders. There is evidence of scapular kinematic alterations associated with shoulder impingement, rotator cuff tendinopathy, rotator cuff tears, glenohumeral instability, adhesive capsulitis, and stiff shoulders. There is also evidence for altered muscle activation in these patient populations, particularly, reduced serratus anterior and increased upper trapezius activation. Scapular kinematic alterations similar to those found in patient populations have been identified in subjects with a short rest length of the pectoralis minor, tight soft-tissue structures in the posterior shoulder region, excessive thoracic kyphosis, or with flexed thoracic postures. This suggests that attention to these factors is warranted in the clinical evaluation and treatment of these patients. The available evidence in clinical trials supports the use of therapeutic exercise in rehabilitating these patients, while further gains in effectiveness should continue to be pursued. Level 5.
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            Asymmetric resting scapular posture in healthy overhead athletes.

            Observation of the scapular posture is one of the most important components of the physical examination in overhead athletes. Postural asymmetry is typically considered to be associated with injuries. However, asymmetry in the overhead athlete's scapula may be normal due to the dominant use of the limb. To quantify the differences in resting scapular posture between the dominant and nondominant sides in 3 groups of healthy overhead athletes (baseball pitchers, volleyball players, and tennis players) using an electromagnetic tracking device. Cross-sectional design. University-based biomechanics laboratory. A total of 43 players participated, including 15 baseball pitchers, 15 volleyball players, and 13 tennis players. All participants were healthy college-aged men. Bilateral 3-dimensional scapular kinematics with the arm at rest were measured using an electromagnetic tracking device. Bilateral scapular position and orientation were measured. Between-groups and between-sides differences in each variable were analyzed using separate analyses of variance. In tennis players, the scapula was more protracted on the dominant side than on the nondominant side (P < .05). In all overhead athletes, the dominant-side scapula was more internally rotated (P = .001) and anteriorly tilted (P = .001) than the nondominant-side scapula was. The dominant-side scapula of the overhead athletes was more internally rotated and anteriorly tilted than the nondominant-side scapula. The dominant-side scapula of the tennis players was more protracted than that on the nondominant side. Clinicians evaluating overhead athletes need to recognize that scapular posture asymmetry in unilateral overhead athletes may be normal. Our results emphasize the importance of the baseline evaluation in this population in order to accurately assess pathologic change in bilateral scapular positions and orientations after injury.
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              Glenohumeral motion deficits: friend or foe?

              In most shoulder conditions a loss of glenohumeral motion results in shoulder performance impairments. However, in the overhead athlete loss of glenohumeral internal rotation, termed glenohumeral internal rotation deficiency (GIRD), is a normal phenomenon that should be expected. Without a loss of glenohumeral internal rotation the overhead athlete will not have the requisite glenohumeral external rotation needed to throw a baseball at nearly 100 miles per hour, or serve a tennis ball at velocities of 120 miles per hour or more. Not all GIRD is pathologic. The authors of this manuscript have defined two types of GIRD; one that is normal and one that is pathologic. Anatomical GIRD (aGIRD) is one that is normal in overhead athletes and is characterized by a loss of internal rotation of less than 18°-20° with symmetrical total rotational motion (TROM) bilaterally. Pathologic GIRD (pGIRD) is when there is a loss of glenohumeral internal rotation greater than 18°-20° with a corresponding loss of TROM greater than 5° when compared bilaterally. A more problematic motion restriction may be that of a loss of TROM in the glenohumeral joint. Recent evidence supports that a loss of TROM is predictive of future injury to the shoulder in professional athletes. Additionally, external rotation deficiency (ERD), the difference between external rotation (ER) of the throwing shoulder and the non-throwing shoulder of less than 5°, may be another predictor of future shoulder injury and disability.
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                Author and article information

                Contributors
                niederer@sport.uni-frankfurt.de
                Journal
                BMC Sports Sci Med Rehabil
                BMC Sports Sci Med Rehabil
                BMC Sports Science, Medicine and Rehabilitation
                BioMed Central (London )
                2052-1847
                26 April 2021
                26 April 2021
                2021
                : 13
                : 44
                Affiliations
                GRID grid.7839.5, ISNI 0000 0004 1936 9721, Department of Sports Medicine and Exercise Physiology, , Goethe University Frankfurt am Main, ; Ginnheimer Landstraße 39, D-60487 Frankfurt am Main, Germany
                Author information
                http://orcid.org/0000-0002-7690-5418
                Article
                272
                10.1186/s13102-021-00272-6
                8077866
                33902697
                97493969-2afc-49df-ba31-2b2d49adb0e1
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 21 September 2020
                : 15 April 2021
                Funding
                Funded by: Johann Wolfgang Goethe-Universität, Frankfurt am Main (1022)
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2021

                bow,arrow,archery, kinematics,movement behaviour
                bow, arrow, archery, kinematics, movement behaviour

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