Research Roundup: June 2020


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Shoulder Kinematics Impact Subacromial Proximities: A Review of the Literature

Rebecca Lawrence, Jonathan Braman, and Paula Ludewig. Shoulder Kinematics Impact Subacromial Proximities: A Review of the Literature. Brazilian Journal of Physical Therapy 2020; 24(3): 219-230

This review gives a summary of current concepts about the association between shoulder kinematics and subacromial proximities; this is important to understand the relationship between motion and potential mechanisms of pathology.


Key Points
  • Mechanical subacromial impingement contributes to the development of pathology.
  • Understanding the relationship between kinematics and the subacromial space will help identify movement impairments that may be important in the development and possibly prevention of rotator cuff pathology.

  • There are extreme variations in metrics for quantifying the subacromial space.
    • The most common metric is the minimum distance; it quantifies the smallest distance between two structures.
    Two dimensional approaches for visualizing subacromial relationships introduce various sources of error when used to quantify three-dimensional relationships. 
    • e.g. Maginification and projection errors.

  • Changes in glenohumeral and scapular kinematics are associated with changes in subacromial proximities.
  • The effect of scapulothoracic kinematics on subacromial proximities is dependent on the angle of humerothoracic elevation.

  • Humeral elevation impacts subacromial distances; the smallest proximities occur at a lower angle of humeral elevation.
  • Cadaveric studies showed that subacromial contact occurs most frequently between 300 and 900 humeral elevation; however, proximity areas were greatest between 600 and 1200 humeral elevation.
    • This does not consider the location of the rotator cuff tendons.
  • The smallest distance between the rotator cuff tendon insertion and coracoacromial arch occurs between 400 and 750 of humerothoracic elevation.
  • It is important to consider tendon location when interpreting subacromial proximities beyond 900 humeral elevation.
  • In vivo studies report that acromiohumeral distance progressively decreases with increasing humeral elevation.
    • A minimum occurs between approximately750 to 1200 of humerothoracic elevation.
    • This increases again at higher angles.

  • Individuals with dyskinesis experience a higher reduction in acromiohumeral distance than individuals without dyskinesis.
  • The relationship between scapulothoracic upward rotation and subacromial proximities is not absolute but depends on the angle of humerothoracic elevation.
  • Subacromial proximities appear to be mostly affected by alterations in scapulothoracic upward rotation, with or without concurrent alterations in a posterior tilt.
  • Scapular assistance tests can be used to investigate the effects of scapulothoracic kinematics on subacromial distances.


Clinically: Pilates in Practice
  • Build on scapular mobility and stability to provide an optimal base of support for glenohumeral joint biomechanics without compromising the rotator cuff. 
  • Focus on scapular rotation mobility over scapular tilt: supine scapular mobilisations  on the Trapeze Table; side lying shoulder abduction over the Spine Corrector.
  • Use manual facilitation of scapular mobility through exercises: seated arm series on the Reformer; push up prep. 



On the Issue of Developing Creative Players In Team Sports: A Systematic Review And Critic From A Functional Perspective

Stephan Zhano and Ernst-Joachim Hossner. On the Issue of Developing Creative Players in Team Sports: A Systematic Review and Critic from a Functional Perspective. Frontiers in Psychology 2020; 11: 575475

This literature review addresses creativity in team sports and provided recommendations for practice. 38 articles were included in the review; 31 were empirical studies and seven were theoretical papers.


Key Points
  • Creativity is a “critical attribute” of team sports players, as it is associated with being less predictable to the opponent in game situations.
  • In team sports, creativity is generally regarded as a person’s developed ability.
    • A specific action in a game situation is regarded as creative rather than the player him/herself possessing an underlying creative ability.
  • The ability to respond to challenges encountered during a game in spontaneous and imaginative ways relies on both specific movement skills and imagination.

  • Creativity is classified as an element of executive function: “assessing players general executive functions including on-line multiprocessing such as creativity, response inhibition, and cognitive flexibility” (p. 2).
  • The underlying assumption is that divergent thinking that enables a player to perform creative actions on the field.
  • However, specific motor skill-related interventions, as compared to a divergent thinking intervention leads to actions that are rated as more functional and creative, when compared to divergent thinking interventions.
  • A larger set of sensorimotor skills allows for a variety of functional task-solutions to be performed.
    • This increases the probability of actions that seem more creative.

  • Athletes should be supported in detecting and refining their own task solutions.
  • Supporting athletes to continuously adapt and explore alternative ways to achieve the task will enhance their creativity.
    • Creativity is the result of situational skill training.


Clinically: Pilates in Practice 
  • Explore movement! 
  • The more options we have for movement, the more creative and resilient our movement can be.
  • Work on functional tasks in a variety of different ways: thoracic rotation can be explored in flexion/extension/side flexion; it can be explored with an upper limb driver or a lower limb driver; it can be explored on the floor, Wunda Chair, Reformer, or Cadillac.
  • Ask clients to problem-solve movement tasks to support their creativity.



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