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Subscapular neuropathy

Innervation of the muscles of the shoulder girdle, rear view Oversaturated neuropathy as a disease is quite rare, although it can occur quite often among volleyball players. This is inflammation and the occurrence of complete or partial non-conductivity of the suprascapular nerve due to its mechanical infringement. The suprascapular nerve is a short branch of the brachial plexus with the beginning of the fifth and sixth cervical roots. This nerve extends laterally under the scapular-hyoid and trapezius muscles, then it enters the front notch of the upper edge of the scapula in the region of the suprascapular notch or notch under the scapular superior transverse ligament. Then he goes on the back side of the scapula, into the supraspinatus fossa. Then its branching appears, one branch passes through the supraspinatus muscle, and the second – through the scapular spine under the lower scapular transverse ligament into the infraspinatus fossa and the infraspinatus muscle.

This nerve is fixed in three places – at its very beginning, then in the notch above the scapula and below under the transverse ligament. It is in the last two points that it is most often damaged. Injuries to this nerve are most likely a sprain, especially if the athlete made a jerk with movements of the shoulder girdle. In this case, there is a deep pain in the scapular region, sometimes inaccurately localized and aggravated by pressing with a finger and percussion in the scapular notch (this is the so-called Tinel symptom). There is a weakness of the innervated muscle, due to which movements of the arm and shoulder can be disturbed – lifting up, retracting, rotating, the pronational position of the hand may develop when it hangs. The supraspinatus and infraspinatus muscles can sometimes atrophy. Sometimes (approximately in every fourth case), an athlete may inadequately assess these symptoms without paying attention to them, noting only a slight pain in the scapular region, but this did not affect the general condition and performance of the game. Significant atrophy of the right infraspinatus muscle in a professional volleyball player. But in such cases, almost everyone recognizes that this pain gave them some inconvenience in everyday life, for example, when combing. Sometimes such pain becomes intrusive up to the point that the sport has to be abandoned, and further atrophy of the infraspinatus muscle can lead to a serious violation of the coordination of movements, because the opposite muscles will “pull” the damaged ones.

Doctors put forward several versions of the pathogenesis of this disease. This may be an injury, hypertrophy of the scapular transverse ligament, sprain of a muscle and nerve, a cyst of nerve nodes. But the most popular hypothesis is that the cause of the disease is a sprain of the nerve due to the excessive range of motion in the shoulder.

Sometimes volleyball athletes experience axillary neuropathy, which is still more common for baseball players or tennis players. Its cause is the compression of the axillary nerve in the region of the quadrilateral opening.

Risk factors for shoulder injury
attacking 1. Improper muscle use. Volleyball “extinguishing” movement is a direction with maximum ball power to the opponent. In this case, the speed of a volleyball depends directly on the strength of the impact and the duration of contact between the ball and the hand. For maximum strength, brush speed should be maximum. If the correct impact technique was used, then it is the muscles here that play the main role, the flexor muscles in the hip joint and in general on the body, since the muscles of the shoulder and arm experience not such a strong load. In addition, it is easier to control the movements of the hands in the area of ​​the ball. With the wrong technique, the shoulder movements are excessive, and the muscles are too intense activity, as a result – the shoulder is overstrained and there is a chance of injury to the rotational cuff.

2. Abnormal joint movements. The “quenching” blow is carried out by movements in three joints at once: acromioclavicular, shoulder and sternoclavicular. If at the same time the movement is limited in the first and third joints, then the athlete must take his arm back excessively in order to perform a quality kick. In this case, tension arises in the shoulder joint, as a result – trauma of the rotational cuff and “impingement syndrome”.

3. Improper hand raising technique. Serving and striking in volleyball are all three phases of throwing in sequence – lifting, acceleration and tracking. An athlete may have two kinds of movement when lifting. In the first case, the shoulder first rises due to the front bending movement, in the second case, the shoulder is first below the acromion, and then is retracted, horizontally bending until it rises. Experts advise athletes to use the second option, as the first can lead to injury more quickly.

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