Altered Alignment of the Shoulder Girdle and Cervical Spine in Patients With Insidious Onset Neck Pain and Whiplash-Associated Disorder
Abstract
Clinical theory suggests that altered alignment of the shoulder girdle has the potential to create or sustain symptomatic mechanical dysfunction in the cervical and thoracic spine. The alignment of the shoulder girdle is described by two clavicle rotations, i.e, elevation and retraction, and by three scapular rotations, i.e., upward rotation, internal rotation, and anterior tilt. Elevation and retraction have until now been assessed only in patients with neck pain. The aim of the study was to determine whether there is a pattern of altered alignment of the shoulder girdle and the cervical and thoracic spine in patients with neck pain. A three-dimensional device measured clavicle and scapular orientation, and cervical and thoracic alignment in patients with insidious onset neck pain (IONP) and whiplash-associated disorder (WAD). An asymptomatic control group was selected for baseline measurements. The symptomatic groups revealed a significantly reduced clavicle retraction and scapular upward rotation as well as decreased cranial angle. A difference was found between the symptomatic groups on the left side, whereas the WAD group revealed an increased scapular anterior tilt and the IONP group a decreased clavicle elevation. These changes may be an important mechanism for maintenance and recurrence or exacerbation of symptoms in patients with neck pain.
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Three of four studies investigated upper cervical extension.
“Concerning upper cervical posture, three of four studies investigated the upper cervical extension [27,33,38], but the difference was significant only in one of them which included only adults [33].”
From The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis (2019) · cites this paper as [33]
The difference in upper cervical extension was significant only in one study, which included only adults.
“Concerning upper cervical posture, three of four studies investigated the upper cervical extension [27,33,38], but the difference was significant only in one of them which included only adults [33].”
From The Relationship Between Forward Head Posture and Neck Pain: a Systematic Review and Meta-Analysis (2019) · cites this paper as [33]
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- Authors
- Helgadottir, H., Kristjansson, E., Mottram, S., Karduna, A., & Jonsson, H.
- Venue
- Journal of Applied Biomechanics
- Publisher
- Human Kinetics
- Published
- 2011-08
- Volume
- 27
- Issue
- 3
- Pages
- 181-191
- ISSN
- 1065-8483 (ISSN-L)
- 1543-2688
- OpenAlex
- W2151180516
- Cited by
- 63
- References
- 63
- Citations by year
- 2025: 6 · 2024: 4 · 2023: 6 · 2022: 7 · 2021: 7 · 2020: 1 · 2019: 5 · 2018: 2 · 2017: 3 · 2016: 1 · 2015: 5 · 2014: 8 · 2013: 2 · 2012: 5
- FWCI
- 5.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Applied Biomechanics (publishedVersion)
- PubMed (publishedVersion)
- Hirsla (Landspítali University Hospital) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Shoulder Injury and Treatment
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Automotive and Human Injury Biomechanics
- Keywords
- cervical alignment, whiplash-associated disorders, scapular rotation, scapular upward rotation
- MeSH terms
- Adult, Cervical Vertebrae, Female, Humans, Male, Posture, Shoulder, Whiplash Injuries, Neck Pain
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