Hara Test
Original Editor - Wataru Okuyama
Top Contributors - Wataru Okuyama, Kim Jackson and Wanda van Niekerk
Introduction[edit | edit source]
Most players don't know what's wrong with their bodies that prevents them from throwing. Therefore, the players needs to be aware of any abnormal physical findings. The 11 items of shoulder physical examination used by the author were used to help the players experience their own abnormalities. The next step is to improve the accuracy of the diagnosis by incorporating the findings of X-ray and ultrasound examinations, which are supplementary diagnostic methods.When an player comes to the hospital complaining of shoulder pain, it is important to evaluate the player's medical condition, including an imaging evaluation based on his or her physical findings, rather than an imaging evaluation itself. The Hara test is useful for assessing abnormalities in the kinetic chain of upper extremity leading to shoulder pain in patients with throwing disorder and provides a more effective basis to understand the clinical course for a return to pitching[1].
This page presents 11 baseball shoulder physical findings[2].
Scapula Spine Distance: SSD[edit | edit source]
Observe the degree of atrophy of the subspinous muscles and deviation of the scapula.
This phenomenon is also seen in subacromial impingement syndrome in addition to weakness of the periscapularis muscles such as the serratus anterior and rhomboids and decreased stability of the shoulder joint. Deviation of the scapula is assessed by measuring between the medial margin of the scapula and the spinous process of the spine.
Combined Abduction Aest: CAT[edit | edit source]
In this method, the abduction angle is taken as the angle of the scapulohumeral joint, and the angle is measured by abducting the upper limb with the scapula manually fixed.
Horizontal Flexion Test: HFT[edit | edit source]
The horizontal flexion angle is taken as the angle of the scapulohumeral joint as well, and the angle is measured with manual fixation of the scapula.
Muscle Testing of Infraspinatus, Subscapularis & Supraspinatus[edit | edit source]
Assessment of rotator muscle strength, including rotator cuff function, is necessary. The external rotation during descent is assessed as the strength of the muscles including the infraspinatus (ISP), and the internal rotation during descent is assessed as the strength of the muscles including the subscapularis (SSC). The strength to raise the upper limb to 30° diagonally anterior to the droop is assessed as the strength of the muscles including the supraspinatus (SSP).
Elbow Push Test: EPT[edit | edit source]
When a resistance test of the serratus propria muscle is performed against the olecranon in 90 degrees of elbow flexion, weakness or weakness may occur on the pitching side.
From the examination of many athletes with throwing disorders, we noticed several interesting phenomena in the evaluation of the strength of compound movements and used them as functional assessment.
Elbow Extension Test: EET[edit | edit source]
Using the same technique as the manual strength test of the triceps muscle, auto-extension from 100° of elbow flexion in the evaluation of triceps muscle on the side of throwing disorder may cause weakness or weakness.
Loose Test[edit | edit source]
The sulcus test, in which the lateral margin of the acromion is depressed by manually pulling the upper limb downward, and the load and shift test, in which the humeral head is moved back and forth in the descending position, are used to test the instability of the shoulder joint.
Impingement Test[edit | edit source]
The impingement test is a test that reproduces the pain of the second shoulder joint in the subacromial region.
Hyper External Rotation Test: HERT[edit | edit source]
The pain can be reproduced by manual testing, and the patient may complain of pain when performing hyperhorizontal rotation of the shoulder joint in the supine position. The concept of internal impingement, in which rotator cuff articular tears and posterior upper articular injuries collide during pitching, has been proposed as a pathological condition of throwing disorders, and it is useful as a test for reproducing pain caused by internal impingement.
For more information on testing, please click here.
References[edit | edit source]
- ↑ Mihata T. (2015) Current Concepts: Arthroscopic Treatment of Articular-Sided Partial-Thickness Rotator Cuff Tears. In: PARK JY. (eds) Sports Injuries to the Shoulder and Elbow. Springer, Berlin, Heidelberg.
- ↑ Masafumi Hara. Rehabilitation of Throwing Shoulder. The Japanese Journal of Rehabilitation Medicine, 2018, 55.6: 495-501.
