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Quantification of Anterior Translation of the Humeral Head in the Throwing Shoulder

Manual Assessment Versus Stress Radiography

Todd S. Ellenbecker, MS, PT, SCS, CSCS^*,*, Angelo J. Mattalino, MD, Eric Elam, MD and Roger Caplinger, ATC^||

^* Physiotherapy Associates - Scottsdale Sports Clinic, Scottsdale, Arizona
Southwest Sports Medicine, Scottsdale, Arizona
Clinical Diagnostic Radiology, Seattle, Washington
^|| Milwaukee Brewers Baseball Club, Milwaukee, Wisconsin

* Address correspondence and reprint requests to Todd S. Ellenbecker MS, PT, SCS, CSCS, Physiotherapy Associates, Scottsdale Sports Clinic, 9449 North 90th Street, Suite 100, Scottsdale, AZ 85258

Clinical evaluation of humeral head translation relies mainly on manual tests to measure laxity in the human shoulder. The purposes of this study were to determine whether side-to-side differences exist in anterior humeral head translation in professional baseball pitchers, to compare manual laxity testing with stress radiography for quantifying humeral head translation, and to test intrarater reliability of the manual humeral head translation and stress radiography tests. Twenty professional baseball pitchers underwent bilateral manual anterior humeral head translation and stress radiographic tests. Stress radiography was performed by imparting a 15-daN anterior load to the shoulder in 90° of abduction with both neutral and 60° of external rotation and recording the glenohumeral joint translation at rest and under stress in each position. Eight subjects were retested to assess the reliability of these methods. Results showed no significant difference between the dominant and nondominant extremity in the amount of anterior humeral head translation measured manually and with stress radiography, nor significant correlation between anterior humeral head translation measured manually and by stress radiography. Test-retest reliability was moderate-to-poor for the manual humeral head translation test and moderate for stress radiography.

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