title: Do stingers affect scapular kinematics in rugby players?
abstract: BACKGROUND
  Scapular dyskinesis is observed in subjects with pathologic conditions of the shoulder; however, there is limited information about the factors related to scapular dyskinesis among participants in rugby. The purpose of this study was to investigate the incidence, reliability, and relationships between scapular dyskinesis and variables related to the shoulder in high-school rugby players.
  
  
  METHODS
  A total of 164 Japanese high-school rugby players were evaluated with questionnaires, physical examinations, and a video analysis during their preseason. After evaluation of the inter-rater reliability of a classification of scapular dyskinesis, the outcomes were analyzed to assess the relationships between scapular dyskinesis and other variables during the preseason. The data were assessed with a logistic regression analysis calculating the odds ratios (OR).
  
  
  RESULTS
  The inter-rater reliability among 3 blinded observers based on the Fleiss κ value and percentage agreement was .52 and 79.0%, respectively, which indicates that the method is moderately reliable. Scapular dyskinesis was identified in 16 (10.1%) shoulders among 159 players, with type I being prominent. A multivariate logistic regression analysis revealed that a type I dyskinesis was significantly associated with a past history of stingers with projected pain to the affected side of the shoulder (OR, 3.7) and the player's competitive grade at the time of the survey (OR, 3.9).
  
  
  CONCLUSIONS
  Scapular dyskinesis is significantly associated with a past history of stingers. This suggests that stingers are a causative factor of scapular dyskinesis in the rugby population. Our method of evaluating scapular dyskinesis in collision athletes exhibits moderate reliability.
authors: Department of Orthopaedic Surgery, Juntendo University Faculty of Medicine, Bunkyo, Tokyo, Japan. Electronic address: k-saki@luck.ocn.ne.jp.
authors: Takayuki
authors: T
authors: Kawasaki
authors: Mejiro Orthopaedic and Internal Medicine Clinic, Toshima, Tokyo, Japan.
authors: Nobukazu
authors: N
authors: Maki
authors: Mejiro Orthopaedic and Internal Medicine Clinic, Toshima, Tokyo, Japan.
authors: Kyoko
authors: K
authors: Shimizu
authors: Keio University Rugby Football Club, Yokohama, Kanagawa, Japan.
authors: Chihiro
authors: C
authors: Ota
authors: Department of Sports Medicine, International Budo University, Katsuura, Chiba, Japan.
authors: Shingo
authors: S
authors: Urayama
authors: Department of Orthopaedic Surgery, Juntendo University Faculty of Medicine, Bunkyo, Tokyo, Japan.
authors: Shuichi
authors: S
authors: Moriya
authors: Department of Orthopaedic Surgery, Juntendo University Faculty of Medicine, Bunkyo, Tokyo, Japan.
authors: Takefumi
authors: T
authors: Kaketa
authors: Department of Orthopaedic Surgery, Juntendo University Faculty of Medicine, Bunkyo, Tokyo, Japan.
authors: Hideo
authors: H
authors: Kobayashi
authors: Department of Orthopaedic Surgery, Juntendo University Faculty of Medicine, Bunkyo, Tokyo, Japan.
authors: Kazuo
authors: K
authors: Kaneko
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000150:complications / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D003430:Cross-Sectional Studies; D020820:Dyskinesias / Q000503:physiopathology*; D005538:Football / Q000293:injuries* / Q000502:physiology; D006801:Humans; D008297:Male; D010146:Pain; D059348:Peripheral Nerve Injuries / Q000209:etiology / Q000503:physiopathology*; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012540:Scapula / Q000503:physiopathology*; D012782:Shoulder / Q000503:physiopathology; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000503:physiopathology*
keywords: Scapular dyskinesis; burner syndrome; collision sports; rugby; shoulder; stinger