Athletic Shoulder Test
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Background[edit | edit source]
Upper extremity injuries are common in overhead sports, however objective criteria to support back to sport decisions remains limited.In overhead, the shoulder and elbow are at higher risk of injury due to the high forces required to perform sport specific tasks. Overhead sports include but are not limited to basketball, water-polo, Javelin and volleyball. This is because overhead is an extremely skilful movement that demands extraordinary forces on the shoulder complex. Additionally, the majority of shoulder injuries occur in the latter stages of training and matches as a consequence of repeated exposure to tackling, fatigue may contribute to risk  Other risk factors have been defined as basic recommendations for the prevention of recurrent injury and return to play after injury: glenohumeral internal-rotation deficit (GIRD); rotator cuff strength, mainly the strength of the external rotators; and scapular dyskinesis, in particular scapular position and strength.
Since scapular muscles are highly activated to protract, upwardly rotate and stabilise scapula in early pull through of freestyle swimming or at ball impact in volleyball and tennis , their activity will be explored during the Modified- Athletic test.
Purpose[edit | edit source]
The athletic shoulder (ASH) test is used to assess and monitor the shoulder isometric strength of athletes during recovery. It is a novel test developed by Ashworth et al. (2018) to evaluate the neuromuscular activity of the shoulder girdle in contact sports and those that includes overhead actions.
Technique[edit | edit source]
Starting Position : Prone on the floor with the forehead resting on a 4cm foam block and the hand placed on a vertical axis platform.
Procedure:[edit | edit source]
The subject will push down from the shoulder in three consecutive test positions maximally for 3 seconds:
- I-test: Shoulder positioned in full abduction (180°), forearm in pronation and elbow in full extension. Contralateral arm at the side.
- Y-test: Shoulder positioned at 135°, forearm in pronation and elbow in full extension. The contralateral arm placed behind the back
- T-test: Shoulder positioned at 90°, forearm in pronation and elbow in full extension. The contralateral arm is placed behind the back.
Evidence[edit | edit source]
The test demonstrates excellent reliability, but further studies are needed to assess its sensitivity.
- Absolute reliability (SEM 4.8–10.8).
- Interday measurement error was below 10% in all test positions (CV 5.0–9.9) except for non-dominant arm I-position (CV 11.3%)".
New findings found results that focus on rugby players at risk of shoulder injuries when performing long lever arm tackles.
Functional Shoulder Test[edit | edit source]
Karlen-Jobe Functional Shoulder Test:
It's clinically relevant to aid in clearance of an athlete for return to overhead sports.
Hypothesis:previous tests evaluated the reliability of a series of tests using portable force plates in various positions (I, Y, T) which made to mimic motions in rugby and found excellent reliability, However, these tests were made as a return to tackling test in rugby, which has different demands in comparison to overhead sports. This is due to the higher demand of the Dynamic Stabilisers of the Shoulder Complex through throwing activities
Shoulder testing positions included: I, Y, Internal rotation (IR), & External Rotation (ER) of the shoulder. It consists of 4 positions, 3 prone and 1 supine position.
Testing protocol: Subject performs 3 trials in each position. In the prone testing positions (I, Y, IR), subjects were directed to maintain their scapula in a neutral position relative to the upper extremity being tested (no winging, anterior tilt, or excessive upward rotation).
Each subject has to press down with maximal effort and verbal encouragement is provided at the start of the test. Each attempt consisted of 3 seconds of exertion, alternating with 5 seconds of rest. A 20 second recovery was used between test positions.
The entire testing protocol took less than 10 minutes per subject, including warm-up and recovery periods.
Modified - Athletic Shoulder Test[edit | edit source]
The Modified-Athletic Shoulder Test (M-AST) is a promising alternative, utilising a handheld dynamometer for the easier test implementation. The use of a handheld dynamometer to appreciate muscle function has become more popular in the last years for its accessibility and its cost 
A strong concordance was found between ASH Test and M-AST values (ICC = 0.86–0.97; p > 0.05) in all the positions.Therefore, the Modified-Athletic Shoulder Test (M-AST) constitutes a reliable, quick and easy to implement test to measure performance and return to play capacity in a non-rotational plane of movements in overhead athletes. The recovery status after training sessions/matches could also be monitored with this test. However there was a raised concern on its reliability due to the lack of consensus regarding the test protocols and sources of measurement errors.
Summary[edit | edit source]
Existing upper limb strength assessments are typically short lever tests that do not mimic sports specific actions or adequately assess higher shear forces experienced during competition.
The M-AST can be a useful tool for sports medicine professionals, coaches, and athletes to evaluate shoulder joint function and to monitor progress during rehabilitation.
Resources[edit | edit source]
References[edit | edit source]
- -Kerlan-Jobe-Functional-Shoulder-Test-Reliability-of-an-upper-extremity-isometric-strength-test.er Z, Cady A, Serrano B, Banffy M. Research Article Advances in Orthopedics and Sports Medicine AOASM-172 ISSN 2641-6859.
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