Scapular kinematic alterations during arm elevation with decrease in pectoralis minor stiffness after stretching in healthy individuals

Background: Pectoralis minor tightness may be seen in individuals with scapular dyskinesis, and stretching is used for the treatment of altered scapular motion in sports and clinical fields. However, few researchers have reported on the effects of pectoralis minor stiffness on scapular motion during arm elevation. This study investigated whether an acute decrease of pectoralis minor stiffness after stretching changes the scapular motion during arm elevation. Methods: The study allocated 15 dominant and 15 nondominant upper limbs in healthy men as control and interventional limbs, respectively. In the intervention limb group, the shoulder was passively and horizontally abducted at 150° of elevation for 5 minutes to stretch the pectoralis minor muscle. Before and after stretching, an electromagnetic sensor was used to examine 3-dimensional scapular motion during abduction and scaption. Ultrasonic shear wave elastography was used to measure pectoralis minor stiffness before and immediately after stretching and after arm elevation. Results: In the interventional limb, pectoralis minor stiffness decreased by 3.2 kPa immediately after stretching and by 2.5 kPa after arm elevation. The maximal changes in scapular kinematics after stretching were 4.8° of external rotation and 3.3° of posterior tilt in abduction, and 4.5° of external rotation and 3.7° of posterior tilt in scaption. Upward rotation in abduction or scaption did not change. Conclusions: Stretching for the pectoralis minor muscle increases external rotation and posterior tilt of the scapula during arm elevation

Shoulder horizontal abduction stretching effectively increases shear elastic modulus of pectoralis minor muscle

Background: Stretching maneuvers for the pectoralis minor muscle, which involve shoulder horizontal abduction or scapular retraction, are performed in clinical and sports settings because the tightness of this muscle may contribute to scapular dyskinesis. The effectiveness of stretching maneuvers for the pectoralis minor muscle is unclear in vivo. The purpose of this study was to verify the effectiveness of stretching maneuvers for the pectoralis minor muscle in vivo using ultrasonic shear wave elastography. Methods: Eighteen healthy men participated in this study. Elongation of the pectoralis minor muscle was measured for 3 stretching maneuvers (shoulder flexion, shoulder horizontal abduction, and scapular retraction) at 3 shoulder elevation angles (30°, 90°, and 150°). The shear elastic modulus, used as the index of muscle elongation, was computed using ultrasonic shear wave elastography for the 9 aforementioned stretching maneuver-angle combinations. Results: The shear elastic modulus was highest in horizontal abduction at 150°, followed by horizontal abduction at 90°, horizontal abduction at 30°, scapular retraction at 30°, scapular retraction at 90°, scapular retraction at 150°, flexion at 150°, flexion at 90°, and flexion at 30°. The shear elastic moduli of horizontal abduction at 90° and horizontal abduction at 150° were significantly higher than those of other stretching maneuvers. There was no significant difference between horizontal abduction at 90° and horizontal abduction at 150°. Conclusions: This study determined that shoulder horizontal abduction at an elevation of 90° and horizontal abduction at an elevation of 150° were the most effective stretching maneuvers for the pectoralis minor muscle in vivo

Acute effects of static stretching on the shear elastic moduli of the medial and lateral gastrocnemius muscles in young and elderly women

Purpose: Generally, static stretching (SS) is the recommended intervention for a decline in the range of motion among elderly adults. However, no study has investigated the acute effects of SS on the shear elastic modulus in elderly people. The aims of the present study were to investigate the acute effects of SS on the shear elastic moduli of the medial and lateral gastrocnemius muscles and to examine the differences in these acute effects between young and elderly women. Methods: This study included 15 healthy young women (age: 23.1 ± 3.4 years) and 15 healthy elderly women (age: 75.9 ± 2.8 years) with no history of neuromuscular disease or musculoskeletal injury involving the lower limbs. The shear elastic moduli of the medial and lateral gastrocnemius muscles (MG and LG, respectively) were measured using ultrasound shear wave elastography at 30° plantar flexion, 0°, and 20° dorsiflexion before and immediately after 5 min of SS with the knee extended. Results: The shear elastic moduli of the MG and LG in all ankle position decreased after SS in both the young and elderly women, and there were no significant differences in the percent changes in the shear elastic moduli of the MG and LG at all ankle positions between the young and elderly women. Conclusions: These results suggested that 5 min of SS might be effective for decreasing shear elastic modulus in both young and elderly women and that the effects on shear elastic modulus are similar between young and elderly women

Acute effect and time course of extension and internal rotation stretching of the shoulder on infraspinatus muscle hardness

Background: A decrease in flexibility of the infraspinatus muscle causes limitations in the range of shoulder motion. Static stretching (SS) is a useful method to improve muscle flexibility and joint mobility. Previous researchers investigated effective stretching methods for the infraspinatus. However, few researchers investigated the acute effect of SS on the infraspinatus muscle's flexibility. In addition, the minimum SS time required to increase the infraspinatus muscle's flexibility remains unclear. The aims of this study included investigating the acute effect of SS on the infraspinatus muscle's hardness (an index of muscle flexibility) by measuring shear elastic modulus and determining minimum SS time to decrease the infraspinatus muscle's hardness. Methods: This included measuring the effect of SS with extension and internal rotation of the shoulder on the infraspinatus muscle's hardness in 20 healthy men. Hence, shear elastic modulus of the infraspinatus was measured by ultrasonic shear wave elastography before and after every 10 seconds up to 120 seconds of SS. Results: Two-way analysis of variance indicated a significant main effect of SS duration on shear elastic modulus. The post hoc test indicated no significant difference between shear elastic modulus after 10 seconds of SS and that before SS. However, shear elastic modulus immediately after a period ranging from 20 seconds to 120 seconds of SS was significantly lower than that before SS. Conclusion: The results suggested that shoulder extension and internal rotation SS effectively decreased the infraspinatus muscle's hardness. In addition, the results indicated that a period exceeding 20 seconds of SS decreased the infraspinatus muscle's hardness

Effects of a Thermal Agent and Physical Activity on Muscle Tendon Stiffness, as Well as the Effects Combined With Static Stretching

Context: A recent review or article reported that thermal agents (TA) or physical activity (PA) can increase range of motion (ROM) and that the combination of TA with stretching is superior to performing stretching only. However, since ROM is affected by the psychological factors, it is questionable whether these studies measured the effect of these interventions on muscle flexibility. By measuring muscle stiffness, the authors attempted to evaluate the effect these interventions on muscle flexibility. Objective: To compare the individual effects of TA and PA on muscle flexibility, as well as their effectiveness when combined with static stretching (SS). Design: Crossover trial. Setting: University research laboratory. Participants: 15 healthy men without a history of orthopedic disease in their lower limbs. Interventions: 15 minutes of 3 different conditions: hot pack as TA, pedaling exercise as PA, and the control group with no TA or PA intervention, followed by 3 min of SS for the hamstrings. Main Outcome Measures: Joint angle and passive torque of the knee during passive elongation were obtained prior to interventions, after 3 kinds of intervention, and after SS. From these data, muscle-tendon-unit (MTU) stiffness of the hamstrings was calculated. Results: Although knee-joint ROM increased with both TA and PA (P < .05), there were no significant differences in MTU stiffness between pre- and postintervention measurements for either of the interventions (TA, P = .477; PA, P = .377; control, P = .388). However, there were similar significant decreases in MTU stiffness between postintervention and post-SS for all conditions (P < .01). Conclusions: TA and PA did not decrease MTU stiffness, and combining these interventions with SS did not provide additional decreases in MTU stiffness compared with performing SS alone

Scapular kinematic and shoulder muscle activity alterations after serratus anterior muscle fatigue

Background: Although the serratus anterior muscle has an important role in scapular movement, no study to date has investigated the effect of serratus anterior fatigue on scapular kinematics and shoulder muscle activity. The purpose of this study was to clarify the effect of serratus anterior fatigue on scapular movement and shoulder muscle activity. Methods: The study participants were 16 healthy men. Electrical muscle stimulation was used to fatigue the serratus anterior muscle. Shoulder muscle strength and endurance, scapular movement, and muscle activity were measured before and after the fatigue task. The muscle activity of the serratus anterior, upper and lower trapezius, anterior and middle deltoid, and infraspinatus muscles was recorded, and the median power frequency of these muscles was calculated to examine the degree of muscle fatigue. Results: The muscle endurance and median power frequency of the serratus anterior muscle decreased after the fatigue tasks, whereas the muscle activities of the serratus anterior, upper trapezius, and infraspinatus muscles increased. External rotation of the scapula at the shoulder elevated position increased after the fatigue task. Conclusion: Selective serratus anterior fatigue due to electric muscle stimulation decreased the serratus anterior endurance at the flexed shoulder position. Furthermore, the muscle activities of the serratus anterior, upper trapezius, and infraspinatus increased and the scapular external rotation was greater after serratus anterior fatigue. These results suggest that the rotator cuff and scapular muscle compensated to avoid the increase in internal rotation of the scapula caused by the dysfunction of the serratus anterior muscle

The reliability of shear elastic modulus measurement of the ankle plantar flexion muscles is higher at dorsiflexed position of the ankle

[Background]Excessive stiffness of lower limb muscles is associated with sports injuries. Therefore, the identification of a reliable measurement of the shear elastic modulus of various ankle plantar flexion muscles is required to evaluate lower leg sports injuries. This study investigated the reliable measurement of the shear elastic modulus of the ankle plantar flexion muscles at different ankle positions. [Methods]Twenty-three healthy young men (25.3 ± 3.6 years, 172.9 ± 5.0 cm, 67.2 ± 7.2 kg) participated in this study. The shear elastic moduli of the ankle plantar flexion muscles including the lateral gastrocnemius, medial gastrocnemius, soleus, peroneus longus, peroneus brevis, flexor hallucis longus, flexor digitorum longus and tibialis posterior were measured using ultrasonic shear wave elastography at 0, 10 and 20° dorsiflexion. [Results]The reliability of the shear elastic modulus measurements for each ankle position was assessed. The results showed that the interday reliability of the measurements differed between ankle positions and that the reliability of the shear elastic modulus measurements at 20° dorsiflexion was higher than that at 10° or 0°. [Conclusion]Our results suggest that measurements at 20° dorsiflexion may provide a more reliable measurement of the shear elastic modulus of ankle plantar flexion muscles

Relationship between scapular initial position and scapular movement during dynamic motions.

Optimal scapular position and movement are necessary for normal function of the shoulder joint and it is essential to focus on scapula in the rehabilitation for shoulder disorders. The aim of this study was to discover the relationship between the scapular initial position and scapular movement during dynamic motions in healthy young men. Thirty-four men participated in this study. The scapular angles at initial position and in elevation and lowering during flexion and abduction were measured using an electromagnetic tracking device. The scapular movements from 30° to 120° during flexion and abduction were calculated. Spearman's rank correlation coefficients were used to analyze the relationship between the scapular initial position and scapular movements. For upward rotation and posterior tilt of the scapula, there were significant positive correlations between the scapular initial position and scapular movement during flexion and abduction. For internal rotation, there were significant positive correlations, except 90° in lowering phase and 120° in both phases. While the humeral elevation increased, the correlation coefficients tended to decrease. Except for the internal rotation our results clarified the interactions between the scapular initial position and scapular movement during dynamic motions in healthy young men. The tendency of the decrease in correlation coefficient with elevation angle was shown

Changes in Passive Properties of the Gastrocnemius Muscle-Tendon Unit During a 4-Week Routine Static Stretching Program.

Context: Static stretching (SS) is commonly performed in a warm-up routine to increase joint range of motion (ROM) and to decrease muscle stiffness. However, the time course of changes in ankle-dorsiflexion (DF) ROM and muscle stiffness during a routine SS program is unclear. Objective: To investigate changes in ankle-DF ROM, passive torque at DF ROM, and muscle stiffness during a routine SS program performed 3 times weekly for 4 wk. Design: A quasi-randomized controlled-trial design. Participants: The subjects comprised 24 male volunteers (age 23.8 ± 2.3 y, height 172.0 ± 4.3 cm, body mass 63.1 ± 4.5 kg) randomly assigned to either a group performing a 4-wk stretching program (SS group) or a control group. Main Outcome Measures: DF ROM, passive torque, and muscle stiffness were measured during passive ankle dorsiflexion in both groups using a dynamometer and ultrasonography once weekly during the 4-wk intervention period. Results: In the SS group, DF ROM and passive torque at DF ROM significantly increased after 2, 3, and 4 wk compared with the initial measurements. Muscle stiffness also decreased significantly after 3 and 4 wk in the SS group. However, there were no significant changes in the control group. Conclusions: Based on these results, the SS program effectively increased DF ROM and decreased muscle stiffness. Furthermore, an SS program of more than 2 wk duration effectively increased DF ROM and changed the stretch tolerance, and an SS program more than 3 wk in duration effectively decreased muscle stiffness

Effective stretching position for the supraspinatus muscle evaluated by shear wave elastography in vivo

[Background]Stretching is useful for increasing flexibility in clinical and athletic situations. Although several authors have recommended various stretching techniques for the supraspinatus muscle, there is no consensus on the effective stretching position owing to a lack of quantitative analysis in vivo. This study used ultrasonic shear wave elastography in vivo to verify the effective stretching positions for the supraspinatus muscle. [Methods]The study participants were 15 healthy male volunteers. The shear elastic modulus, used as the index of supraspinatus muscle elongation, was computed using ultrasonic shear wave elastography. The shear elastic modulus was measured at neutral position and maximum internal rotation in 9 positions: 0° elevation, 90° abduction, 90° flexion, maximum extension, maximum horizontal adduction at 45° and 90° elevation, and maximum horizontal abduction at 20°, 45°, and 90° elevation. [Results]The shear elastic moduli were significantly greater in maximum internal rotation at maximum horizontal abduction with 45° and 90° elevation and maximum internal rotation at maximum extension than those in the other positions. There were no significant differences in the shear elastic moduli among these 3 positions. [Conclusions]This study demonstrated that maximum internal rotation at maximum extension, maximum internal rotation at maximum horizontal abduction with 90° elevation, and maximum internal rotation at maximum horizontal abduction with 45° elevation are effective stretching positions for the supraspinatus muscle