| HOME | HELP | CONTACT US | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Sign In to gain access to subscriptions and/or personal tools.
|
|
|
|||||||
Sign In to gain access to subscriptions and/or personal tools. |
|||||||||
Hughston Orthopaedic Clinic, PC, Columbus, Georgia, and Tulane University School of Medicine, Division of Orthopaedics, Sports Medicine Section, New Orleans, Louisiana
Hughston Orthopaedic Clinic, PC, Columbus, Georgia, and Tulane University School of Medicine, Division of Orthopaedics, Sports Medicine Section, New Orleans, Louisiana
Hughston Orthopaedic Clinic, PC, Columbus, Georgia, and Tulane University School of Medicine, Division of Orthopaedics, Sports Medicine Section, New Orleans, Louisiana
Tears of the glenoid labrum were observed in 73 base ball pitchers and other throwing athletes who under went arthroscopic examination of the dominant shoul der. Most of the tears were located over the anterosu perior portion of the glenoid labrum near the origin of the tendon of the long head of the biceps muscle into the glenoid.
At arthroscopy, the tendon of the long head of the biceps appeared to originate through and be continuous with the superior portion of the glenoid labrum. In many cases it appeared to have pulled the anterosuperior portion of the labrum off the glenoid. This observation was verified at arthroscopy by viewing the origin of the biceps tendon into the glenoid labrum as the muscle was electrically stimulated. With stimulation of the mus cle, the tendinous portion became quite taut, particu larly near its attachment to the glenoid labrum, and actually lifted the labrum off the glenoid.
Three-dimensional high-speed cinematography with computer analysis revealed that the moment acting about the elbow joint to extend the joint through an arc of about 50° was in excess of 600 inch-pounds. The extremely high velocity of elbow extension which is generated must be decelerated through the final 30° of elbow extension. Of the muscles of the arm that provide the large deceleration forces in the follow-through phase of throwing, only the biceps brachii traverses both the elbow joint and the shoulder joint. Additional forces are generated in the biceps tendon in its function as a "shunt" muscle to stabilize the glenohumeral joint during the throwing act.
On the basis of our observations that (1) the biceps tendon is subjected to large forces during throwing, (2) most tears of the glenoid labrum occur at the antero superior portion near the origin of the biceps tendon, and (3) the biceps tendon lifts the labrum off the glenoid when its muscle is stimulated, we believe that the tendon of the long head of the biceps may be a cause of tearing of the glenoid labrum in the throwing athlete.
This article has been cited by other articles:
|
|
 |
|
  R. Gobezie, D. Zurakowski, K. Lavery, P. J. Millett, B. J. Cole, and J. J. P. Warner Analysis of Interobserver and Intraobserver Variability in the Diagnosis and Treatment of SLAP Tears Using the Snyder Classification Am. J. Sports Med., July 1, 2008; 36(7): 1373 - 1379. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Youm, J. E. Tibone, N. S. ElAttrache, M. H. McGarry, and T. Q. Lee Simulated Type II Superior Labral Anterior Posterior Lesions Do Not Alter the Path of Glenohumeral Articulation: A Cadaveric Biomechanical Study Am. J. Sports Med., April 1, 2008; 36(4): 767 - 774. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. H. Oh, J. Y. Kim, W. S. Kim, H. S. Gong, and J. H. Lee The Evaluation of Various Physical Examinations for the Diagnosis of Type II Superior Labrum Anterior and Posterior Lesion Am. J. Sports Med., February 1, 2008; 36(2): 353 - 359. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y.-S. Kim, J.-M. Kim, K.-Y. Ha, S. Choy, M.-W. Joo, and Y.-G. Chung The Passive Compression Test: A New Clinical Test for Superior Labral Tears of the Shoulder Am. J. Sports Med., September 1, 2007; 35(9): 1489 - 1494. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Seroyer, S. G. Tejwani, and J. P. Bradley Arthroscopic Capsulolabral Reconstruction of the Type VIII Superior Labrum Anterior Posterior Lesion: Mean 2-Year Follow-up on 13 Shoulders Am. J. Sports Med., September 1, 2007; 35(9): 1477 - 1483. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. M. Ahrens and P. Boileau The long head of biceps and associated tendinopathy J Bone Joint Surg Br, August 1, 2007; 89-B(8): 1001 - 1009. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. K. Herickhoff, E. Keyurapan, L. M. Fayad, C. E. Silberstein, and E. G. McFarland Scapular Stress Fracture in a Professional Baseball Player: A Case Report and Review of the Literature Am. J. Sports Med., July 1, 2007; 35(7): 1193 - 1196. [Full Text] [PDF]
|
|
|
|
|
|
S. L. Werner, D. G. Jones, J. A. Guido Jr, and M. E. Brunet Kinematics and Kinetics of Elite Windmill Softball Pitching Am. J. Sports Med., April 1, 2006; 34(4): 597 - 603. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. T. Keefe and W. R. Lowe Symptomatic Superior Labral Anterior Posterior Lesion With Absence of the Long Head of the Biceps Tendon: A Case Report Am. J. Sports Med., November 1, 2005; 33(11): 1746 - 1750. [Full Text] [PDF]
|
|
|
|
|
|
T. H. Myers, J. R. Zemanovic, and J. R. Andrews The Resisted Supination External Rotation Test: A New Test for the Diagnosis of Superior Labral Anterior Posterior Lesions Am. J. Sports Med., September 1, 2005; 33(9): 1315 - 1320. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Ide, S. Maeda, and K. Takagi Sports Activity After Arthroscopic Superior Labral Repair Using Suture Anchors in Overhead-Throwing Athletes Am. J. Sports Med., April 1, 2005; 33(4): 507 - 514. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. S. Tarkin, C. M. Morganti, D. A. Zillmer, E. G. McFarland, and C. E. Giangarra Rotator Cuff Tears in Adolescent Athletes Am. J. Sports Med., April 1, 2005; 33(4): 596 - 601. [Full Text] [PDF]
|
|
|
|
|
|
M.-L. Yeh, D. Lintner, and Z.-P. Luo Stress Distribution in the Superior Labrum During Throwing Motion Am. J. Sports Med., March 1, 2005; 33(3): 395 - 401. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. H. Kim, P. J. Millett, J. J. P. Warner, and F. W. Jobe Shoulder Injuries in Golf Am. J. Sports Med., July 1, 2004; 32(5): 1324 - 1330. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. F. Shepard, J. R. Dugas, N. Zeng, and J. R. Andrews Differences in the Ultimate Strength of the Biceps Anchor and the Generation of Type II Superior Labral Anterior Posterior Lesions in a Cadaveric Model Am. J. Sports Med., July 1, 2004; 32(5): 1197 - 1201. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Davidson and D. W. Rivenburgh Mobile Superior Glenoid Labrum: A Normal Variant or Pathologic Condition? Am. J. Sports Med., June 1, 2004; 32(4): 962 - 966. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. A. DiRaimondo, J. W. Alexander, P. C. Noble, W. R. Lowe, and D. M. Lintner A Biomechanical Comparison of Repair Techniques for Type II SLAP Lesions Am. J. Sports Med., April 1, 2004; 32(3): 727 - 733. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. V. R. Mohana-Borges, C. B. Chung, and D. Resnick Superior Labral Anteroposterior Tear: Classification and Diagnosis on MRI and MR Arthrography Am. J. Roentgenol., December 1, 2003; 181(6): 1449 - 1462. [Full Text] [PDF]
|
|
|
|
|
|
E. K. Nam and S. J. Snyder Clinical Sports Medicine Update. The Diagnosis and Treatment of Superior Labrum, Anterior and Posterior (SLAP) Lesions Am. J. Sports Med., September 1, 2003; 31(5): 798 - 810. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Q. Ly, D. P. Beall, and T. G. Sanders MR Imaging of Glenohumeral Instability Am. J. Roentgenol., July 1, 2003; 181(1): 203 - 213. [Full Text] [PDF]
|
|
|
|
 |
|
 A. G. Rao, T. K. Kim, E. Chronopoulos, and E. G. McFarland Anatomical Variants in the Anterosuperior Aspect of the Glenoid Labrum: A Statistical Analysis of Seventy-three Cases J. Bone Joint Surg. Am., March 31, 2003; 85(4): 653 - 659. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. K. Kim, W. S. Queale, A. J. Cosgarea, and E. G. McFarland Clinical Features of the Different Types of SLAP Lesions: An Analysis of One Hundred and Thirty-nine Cases J. Bone Joint Surg. Am., January 17, 2003; 85(1): 66 - 71. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Burkart, R. E. Debski, V. Musahl, and P. J. McMahon Glenohumeral Translations are Only Partially Restored after Repair of a Simulated Type II Superior Labral Lesion Am. J. Sports Med., January 1, 2003; 31(1): 56 - 63. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. B. Stetson and K. Templin The Crank Test, the O'Brien Test, and Routine Magnetic Resonance Imaging Scans in the Diagnosis of Labral Tears Am. J. Sports Med., November 1, 2002; 30(6): 806 - 809. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-H. Kim, K.-I. Ha, S.-H. Kim, and H.-J. Choi Results of Arthroscopic Treatment of Superior Labral Lesions J. Bone Joint Surg. Am., June 1, 2002; 84(6): 981 - 985. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. L. Pradhan, E. Itoi, Y. Hatakeyama, M. Urayama, and K. Sato Superior Labral Strain during the Throwing Motion: A Cadaveric Study Am. J. Sports Med., July 1, 2001; 29(4): 488 - 492. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. L. Werner, T. J. Gill, T. A. Murray, T. D. Cook, and R. J. Hawkins Relationships between Throwing Mechanics and Shoulder Distraction in Professional Baseball Pitchers Am. J. Sports Med., May 1, 2001; 29(3): 354 - 358. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Murray, T. D. Cook, S. L. Werner, T. F. Schlegel, and R. J. Hawkins The Effects of Extended Play on Professional Baseball Pitchers Am. J. Sports Med., March 1, 2001; 29(2): 137 - 142. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. A. Tung, D. Entzian, A. Green, and J. M. Brody High-Field and Low-Field MR Imaging of Superior Glenoid Labral Tears and Associated Tendon Injuries Am. J. Roentgenol., April 1, 2000; 174(4): 1107 - 1114. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Meister Injuries to the Shoulder in the Throwing Athlete: Part One: Biomechanics/Pathophysiology/Classification of Injury Am. J. Sports Med., March 1, 2000; 28(2): 265 - 275. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Mimori, T. Muneta, T. Nakagawa, and K. Shinomiya A New Pain Provocation Test for Superior Labral Tears of the Shoulder Am. J. Sports Med., March 1, 1999; 27(2): 137 - 142. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. A. Connell, H. G. Potter, T. L. Wickiewicz, D. W. Altchek, and R. F. Warren Noncontrast Magnetic Resonance Imaging of Superior Labral Lesions: 102 Cases Confirmed at Arthroscopic Surgery Am. J. Sports Med., March 1, 1999; 27(2): 208 - 213. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. D. Mair, R. Zarzour, and K. P. Speer Posterior Labral Injury in Contact Athletes Am. J. Sports Med., November 1, 1998; 26(6): 753 - 758. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. C. TEITZ, W. E. GARRETT JR., A. MINIACI, M. H. LEE, and R. A. MANN Instructional Course Lectures, The American Academy of Orthopaedic Surgeons - Tendon Problems in Athletic Individuals*{{dagger}} J. Bone Joint Surg. Am., January 1, 1997; 79(1): 138 - 52. [Full Text]
|
|
|
|
|
|
S. H. Liu, M. H. Henry, and S. L. Nuccion A Prospective Evaluation of a New Physical Examination in Predicting Glenoid Labral Tears Am. J. Sports Med., December 1, 1996; 24(6): 721 - 725. [Abstract] [PDF]
|
|
|
|
|
|
S. H. Liu, M. H. Henry, S. Nuccion, M. S. Shapiro, and F. Dorey Diagnosis of Glenoid Labral Tears: A Comparison Between Magnetic Resonance Imaging and Clinical Examinations Am. J. Sports Med., March 1, 1996; 24(2): 149 - 154. [Abstract] [PDF]
|
|
|
|
|
|
B. Hintermann and A. Gachter Arthroscopic Findings After Shoulder Dislocation Am. J. Sports Med., September 1, 1995; 23(5): 545 - 551. [Abstract] [PDF]
|
|
|
|
|
|
D. R. Martin and W. P. Garth Jr. Results of Arthroscopic Debridement of Glenoid Labral Tears Am. J. Sports Med., July 1, 1995; 23(4): 447 - 451. [Abstract] [PDF]
|
|
|
|
|
|
G. S. Fleisig, J. R. Andrews, C. J. Dillman, and R. F. Escamilla Kinetics of Baseball Pitching with Implications About Injury Mechanisms Am. J. Sports Med., March 1, 1995; 23(2): 233 - 239. [Abstract] [PDF]
|
|
|
|
|
|
M. W. Maffet, G. M. Gartsman, and B. Moseley Superior Labrum-Biceps Tendon Complex Lesions of the Shoulder Am. J. Sports Med., January 1, 1995; 23(1): 93 - 98. [Abstract] [PDF]
|
|
|
|
|
|
C. L. Baker and S. H. Liu Comparison of Open and Arthroscopically Assisted Rotator Cuff Repairs Am. J. Sports Med., January 1, 1995; 23(1): 99 - 104. [Abstract] [PDF]
|
|
|
|
|
|
M. R. Green and K. P. Christensen Magnetic Resonance Imaging of the Glenoid Labrum in Anterior Shoulder Instability Am. J. Sports Med., July 1, 1994; 22(4): 493 - 498. [Abstract] [PDF]
|
|
|
|
|
|
G. C. Terry, S. J. Friedman, and T. L. Uhl Arthroscopically Treated Tears of the Glenoid Labrum: Factors Influencing Outcome Am. J. Sports Med., July 1, 1994; 22(4): 504 - 512. [Abstract] [PDF]
|
|
|
|
|
|
M. W. Rodosky, C. D. Harner, and F. H. Fu The Role of the Long Head of the Biceps Muscle and Superior Glenoid Labrum in Anterior Stability of the Shoulder Am. J. Sports Med., January 1, 1994; 22(1): 121 - 130. [Abstract] [PDF]
|
|
|
|
|
|
L. D. Field and F. H. Savoie III Arthroscopic suture repair of superior labral detachment lesions of the shoulder Am. J. Sports Med., December 1, 1993; 21(6): 783 - 790. [Abstract] [PDF]
|
|
|
|
|
|
F. A. Cordasco, S. Steinmann, E. L. Flatow, and L. U. Bigliani Arthroscopic treatment of glenoid labral tears Am. J. Sports Med., June 1, 1993; 21(3): 425 - 431. [Abstract] [PDF]
|
|
|
|
|
|
T. J. Greenan, M. B. Zlatkin, M. K. Dalinka, and J. L. Esterhai Posttraumatic changes in the posterior glenoid and labrum in a handball player Am. J. Sports Med., January 1, 1993; 21(1): 153 - 156. [PDF]
|
|
|
|
|
|
D. W. Altchek, R. F. Warren, T. L. Wickiewicz, and G. Ortiz Arthroscopic labral debridement: A three-year follow-up study Am. J. Sports Med., December 1, 1992; 20(6): 702 - 706. [Abstract] [PDF]
|
|
|
|
|
|
W. C. McMaster, S. C. Long, and V. J. Caiozzo Shoulder torque changes in the swimming athlete Am. J. Sports Med., June 1, 1992; 20(3): 323 - 327. [Abstract] [PDF]
|
|
|
|
|
|
W. C. McMaster, S. C. Long, and V. J. Caiozzo Isokinetic torque imbalances in the rotator cuff of the elite water polo player Am. J. Sports Med., January 1, 1991; 19(1): 72 - 75. [Abstract] [PDF]
|
|
|
|
|
|
J. A. Hurley and T. E. Anderson Shoulder arthroscopy: its role in evaluating shoulder disorders in the athlete Am. J. Sports Med., September 1, 1990; 18(5): 480 - 483. [Abstract] [PDF]
|
|
|
|
|
|
M. L. Gross, L. L. Seeger, J. B. Smith, B. R. Mandelbaum, and G. A.M. Finerman Magnetic resonance imaging of the glenoid labrum Am. J. Sports Med., June 1, 1990; 18(3): 229 - 234. [Abstract] [PDF]
|
|
|
|
|
|
M. Raf, J. Minkoff, J. Bonamo, H. Firooznia, L. Jaffe, C. Golimbu, and O. Sherman Computed tomography (CT) arthrography of shoulder instabilities in athletes Am. J. Sports Med., July 1, 1988; 16(4): 352 - 361. [Abstract] [PDF]
|
|
|
|
|
|
R. Y. Hinton Isokinetic evaluation of shoulder rotational strength in high school baseball pitchers Am. J. Sports Med., June 1, 1988; 16(3): 274 - 279. [Abstract] [PDF]
|
|
|
|
|
|
W. P. Garth JR, F. L. Allman JR, and W. S. Armstrong Occult anterior subluxations of the shoulder in noncontact sports Am. J. Sports Med., December 1, 1987; 15(6): 579 - 585. [Abstract] [PDF]
|
|
| HOME | HELP | CONTACT US | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
