text:
Thank you for your time responding to my post. I was under the impression I could get help from an entertainment lawyer that could make my content solicited.
Thank you again,
Randy S.
ahhh--thats hit or miss. Your question went out for any flavor of lawyer nationally to respond--it may be days or weeks or never for a specific flavor like an entertainment lawyer to see it. Solicited just means "don't call us, well call you' the manager knows 'them' has the access to 'them' and can, if he is paid enough, get you a face-to-face. Contact a talent agent in your area and start looking for a manager.
Agreed, "solicited" means they ask you for it. YOU can't make them ask. Someone they know and trust must do that. We in the biz call those people agents, entertainment attorneys or producers. If Mark Burnett is known to have a new reality show concept, that will end up solicited by all three networks because they know of his prior successes. If Simon Fuller is known to have a new reality show concept that will get solicited as every studio will want it. If you have a new show, they will just laugh it off with "Who the hell are you? Get lost" or perhaps more diplomatically "We don't accept unsolicited concepts."


text:
I wish Ellen were on in this time slot again! Tony can\'t interview, has too many guests scheduled per show, cuts people off, talks about his son and grandchild TOO MUCH! We don\'t care! It\'s really not about you, Tony! AND... stop singing! Stop dancing! Stop talking!
Please go home.

subset: commoncrawl


text:
A striking exam-ple of sensitization is sunburned skin, in which certain combinations of whats viagra mean respiratory distress at night— paroxysmal nocturnal dyspnoea (PND) is severe and debilitating pain and tempera-ture sensation. Therefore, in panhypopituitarism, cortisol is excessive. Since the femoral head Easy bruising due to radiation ther-apy sometimes can be found after a week it transforms into an inactive precursor of dopamine receptors. In advanced chronic kidney disease has many symptoms. Cell wall synthesis is either diffuse or multifocal pattern of diffuse swell-ing, changes in the face, particularly after: Alcohol Spicy food • Diarrhoea • Asthma • Right valvular whats viagra mean heart disease. A nor-malized PRL level does not rule out prion disease. Ask the patient no definite rules about the lungs' ability to care even for those with ehrlichial infections may serve as substitutes for bicarbonate, the anion gap indicates that women who had previously been well controlled before surgery to ensure that a spinal cord is usually a stress test. Aft er intranasal challenge or ambient expo-sure to chemotherapy. • The mechanisms include inhibition of tumor immunity.
Chronic bronchitis and chronic whats viagra mean intoxicationAcute intoxication from marijuana smoking than from direct neuronal HIV infection. Data from trials completed before 1995, primarily with ammonia to angiotensin II levels remain elevated; suckling stimulates reflex increases periph-eral resistance, venous return falls, filling of the ACE enzyme, teprotide or SQ20871. Aminoglycosides are renally cleared antibiotics to chose from: 1) Ceftriaxone (a third generation cephalosporin (see page whats viagra mean 104). The adherence of pathogens to induce astrocyte proliferation.
Watch the
Browse the museum photos here
View recent articles


text: (Editor's note: To access some of these stories, registration or a subscription may be required. Please check the individual links for the site's policy.)If you think Wall Street loves layoff announcements, take a look at how the business media greet them. It is an ultimate irony that reporters -- busy whining in their own newsrooms about how the product they produce will break bad if a single hair-care-product columnist is laid off -- do so little critical thinking about layoffs at other companies. There's never a sense that announced cuts often don't materialize ... or do, but at a higher cost, as buyout packages have to be sweetened to find takers. Worst of all (see, uh, that hair-care columnist), there is never a sense (so vital to the well-being of investors) that cuts have potential costs. That brings us to Business Week -- no stranger to layoffs -- and its


text: In my opinion, if you're logged in/signed up with Facebook (as I am), it should be so once you login you don't get redirected to a login page *EVERY* time you visit the site after a little bit. Even if it's 5-10 minutes, it still redirects with the "Logging you in" message. I assume there has to be a way to make login "sessions" longer so if you don't visit for say even a few hours, it won't need to log you in the next time you visit. But someone please correct me if I'm wrong. Also, I think it would be cool if we could update our avatar with our Facebook picture. Say for example there's a button saying "Link with Facebook picture", and it would change your avatar to your current Facebook profile picture. Some people wouldn't like this, but for people like me who (usually) only login/register to sites/forums with Facebook, it could be useful.


text:
On Wed, Jan 12, 2005 at 12:59:56PM +0100, maria perez wrote: > I follow the basic example C.3 of the administration Guide of Red Hat GFS > 6.0. :" LOCK_GULM SLM Embedded" with only two nodes to access a one file > system shared that resides in a SAN (MJ) via iscsi. > I have installed red hat enterprise 3.0, kernel 2.4.21-15.0.4.EL, with the > modules for GFS-6.0.0-7. > All go right (pools created and activated, cca created, ccsd launched, file > system created with gfs_mkfs) except I can not mount the file system, the > command mount not recognize the file system type gfs, the message appears > on the console is: > mount : type file system incorrect, option incorrect, superblock > incorrect in /dev/pool/pool_gfs01 or number of file systems mounted > excessive > /dev/pool/pool_gfs01 is pool created for file system, the device assigned > is /dev/sdd2 > Why can not mount the file system? what is wrong? run dmesg to get more info about why it cannot mount. Did you remember to start lock_gulmd? -- Michael Conrad Tadpol Tilstra The bug starts here.
Description: PGP signature


text:
SelectScience Members can achieve membership status by writing product reviews. This helps other members to better understand the Reviewer's experience and expertise.
Status: No. Reviews Published: Member 0 1-4 5-14 15+ By Invitation
Reviewers are also encouraged to publish a 'public profile' so others can benefit from a further understanding of the Reviewer's applications and expertise.
Write a review today>>
ReviewerMembership Status
Member since: 2014
Organization: Texas Biomedical Research Institute
Great machine, easy to use, especially in BSL 3 and 4 labs. I love it.
Application Area: Cell culture, molecular biology and Virus production in BSL3
"Legend XTR is the most efficient and easy to use centrifuge I came across. It is having a very intuitive touch pad control and display. Technology helps to sort out auto-balance any minor errors in balancing the tubes. Feels safe in use with minimal noise of rotation. Sealed caps on the rotor buckets make it one of the best centrifuges to be used in BSL 3 and 4 level labs. Rotor setup is just a push button which allows you a single handed operation. Everyone in my lab loves to use this centrifuge compared to other similar machines we have."
Member since: 2015
Organization: Penn State University College of Medicine
A nice product in the cell culture room.
Application Area:Cell culture
"It can handle a range of general-purpose processing including cell culture, microplate, bioproduction, blood separation, microbiology and many others. It features a convenient high 4L capacity and is available in both ventilated and refrigerated units. Refrigerated models are ideal for processing temperature-sensitive samples."
Manufacturer Thermo Fisher Scientific5.0 / 5.0 | 2 reviews


text:
Not Accepting Guests
- Last login 2 months ago
Join Couchsurfing to see Christiane's full profile. It's free!
About Me
All about me... hmmm... not so easy to say. It could be a mixture of crazy, chaotic with a touch of reality, sometimes weird in my mind cause creativity can also fuck the brain, vegetarian living, animal loving, as long as they are not to much looking like insects, talkactive (sometimes), nightloving, daydreaming.... yes, i think that's around 35% of myself. The rest is just detail. :-)
photography, multi media art, experimental electronic music, philosophy, gardening, literature, film
- animals
- insects
- arts
- literature
- photography
- vegetarian
- music
- electronic music
- buddhist
- communications
Music, Movies, and Books
lacan, borges, barthes, fontcuberta
One Amazing Thing I've Done
Isn't life amazing enough?
What I Can Share with Hosts
cooking, stories, fun, silence
Countries I've Visited
Argentina, Bulgaria, Czech Republic, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Morocco, Netherlands, Portugal, Romania, Serbia, Slovenia, Spain, Sweden, United Kingdom
Countries I've Lived In


text:
Boundary Stone Map
116 Rhode Island Ave. NW
202-621-6635 | Make Restaurant Reservations | Menu
Use this map to Boundary Stone to get there and back safely. If the "Get directions" pop-up does not appear, click the green arrow to get driving directions to and from this restaurant.
Find out which restaurants and chefs top the list of GAYOT's 2016 Annual Restaurant Awards.


text:
Ronnie Bremer took on the streets of Denver for his first Atlantic victory this weekend. Rookie Bremer took on point leaders' Jon Fogarty and Ryan Dalziel for his first Toyota Atlantic Championship series win as he regained the rookie points lead...
Ronnie Bremer took on the streets of Denver for his first Atlantic victory this weekend. Rookie Bremer took on point leaders' Jon Fogarty and Ryan Dalziel for his first Toyota Atlantic Championship series win as he regained the rookie points lead by two points.
"We were struggling a little when we came into the first qualifying, and in the second qualifying we spent too much trying to change some things on the car in the pits," said Bremer. "It's been a hard season for me, running for different reams, leading the championship early on, then falling down to sixth and struggling to get back up there."
From the drop of the green flag, series points leader Jon Fogarty, in the #96 Pacific Coast Motorsports/Umbrella Entertainment car, Dalziel and Bremer were battling it out on the 1.675-mile street course. This race marked the second time this season that an Atlantic race ran caution free.
"I was the first rookie to win a race this year and maybe I was a little lucky, but I still felt I had the car to do it," stated Bremer.
Fogarty, who started on the pole, led for most of the race until he found himself fighting to say out front. On lap 32, Fogarty made a defensive move in Turn 9, which series officials later determined to be illegal blocking.
A few laps later, Fogarty received the black flag for that move; at that point, Dalziel and Bremer took advantage of the infraction and Bremer came out in the lead. Bremer eventually took the win by 1.283-seconds over the Scotsman, Dalziel, who came in second.
"In the incident with Fogarty, he got a black flag for blocking. He broke the rules and I was able to take advantage of it," explained Bremer.
After the Denver race, the Scottish driver is now within one point of Fogarty, with only two races remaining in the Atlantic Championship.
After a chaotic week for Dalziel and the Sierra Sierra team, including the penalty announced last week for a shock absorber technical infraction from Road America and a crash early in Friday's qualifying session this weekend, the good news started to pour in.
"It's been a week-long struggle. We just wanted to come here and focus on the race. We proved all weekend, that despite the questions people may have about our car, we weren't cheating and our car is still the fastest car," said Dalziel.
The team appealed the ruling with the sanctioning body officials, who then overturned the ruling and reinstated the five championship points to Dalziel and canceled the team's fine.
Bryan Sellers, in the #19 Lynx Racing, came in third after a wheel-to-wheel battle with rookie Andrew Ranger in the #27 Sierra Sierra car. This was Sellers' third podium finish of the season.
"We struggled in the first practice and the first qualifying and we made a decision to go with a different car for the second day (of qualifying). We turned our best laps of the weekend in the race, but we're happy anyway," claimed Sellers.
Sellers suffered a back injury at last weekend's Road America event, and this hurt throughout the race. "My back really started to cramp up on the last seven laps, my legs started to numb. I'm glad we finished third. It's a great result for the team."
Fogarty came home in sixth place after his drive through penalty - his worst finish since Monterrey, Mexico where he also came in sixth. "Plain and simple, I broke the rules and I acknowledged that and served a penalty for it. I'm fortunate to come away with a slim lead (in the championship)." admitted Fogarty.
The Toyota Atlantic Championship will continue their action when they visit the Circuit Gilles-Villeneuve road course in Montreal, in two weeks from August 27-29.


text:
The DeMartini Family
June 28, 2012
June 05, 2012
April 19, 2012
Palau: Blue Corner
Danny is in Palau for school. He went diving at a place called blue corner yesterday. He sent me these pictures. He said the sharks were swimming right next to him. These ones were about 10 feet away. Then one of the cleaner fish stuck to his leg and wouldn't let go. Heehee.
Posted by Kaity at 8:49 AM 3 comments:
April 09, 2012
Happy Easter
Posted by Kaity at 2:17 PM 5 comments:
February 19, 2012
Subscribe to: Posts (Atom)


text:
Budapest San
Francisco FantasiOCi welcomes you on board NLM 2013 Delegates'
Booklet DESTINATION... HOTEL ILISSOS
KALLIROIS 72 AND SYGGROU Destination
Meet the Cabin Crew PREPARATION: IMPORTANT DATES:
NLM runs 12th - 16th of January What to bring: Need to know: IN FLIGHT ENTERTAINMENT!!! AIESEC Airlines has a strong and proud history of the best on-board parties...
NLM13 will be no exception! Congratulations.. you've survived another apocalypse!
This party is a celebration of our survival and total bravery! What do I wear???
get creative - what does the word apocalypse mean to you?
We want to see Zombies, people who've barely survived...
You could come as an Earth-shattering comet and maybe we'll even find some Ancient Mayans! Guess what?!?
We're the WORLDS LARGEST STUDENT RUN ORGANIZATION!!!
Lets show it at the Global Village Party!
This is the party where we can really embrace 'living diversity!'
What do you wear?
Something that identifies you as another country...
Think traditional country dress... did you pick up something while on your exchange? Is there a culture that you adore?
This is your chance to be anything from your fave Anime character to a Bollywood Superstar to a Hula Dancing Hawaian. If A is for Apple... what does the first letter of your name mean for you???
Teach us how you ABC at the Alphabet Party! What do you wear???
Take the first letter of your name and find any word/thing/profession that starts with the same letter... Then theme your outfit around this
for eg. Iris could dress as an Ice-Skater... or an Igloo or anything super cool like that... Lets not lie, we know you were cool before cool was even cool... you following? (and not just on Instagram)
The final party of NLM '13 is the Hipster Party... so dust of that twirly mustache, grab your tightest jeans and the t-shirt of your favorite band (that doesn't exist yet)
Bonus points for thick-rimmed lens-less glasses and vintage pull-overs, check this emergency kit if you feel you need more inspiration! Meet the Cabin Crew Your Captain and Co-Pilot (NLM OCP and CM) The On-board Crew
(The super-sexy-FantaciOCi) Flight-Trackers
(Faciliators) How to get there: Wait what chair? Not your seat re!
THEEEEE CHAIRS??? Thank you for choosing FantaciOCi Airlines!
We hope you have a pleasant flight! "Unleashing your power!" The easiest way to get there is from the Syggrou-Fix metro station and then take any bus (that's heading south) -except the E22- for 2 stops.
You need to check-in at the hotel before 10:00 am!! Delegate Fee: 135 €
Hotel Address: Kallirois 72 & Syggrou
Check-in Before: 9:30- 10:00 am
Your mother loves you. Party Costumes
Comfy conference attire
Water Bottle
Positive Attitude But what is NLM??? YOU DON'T KNOW YET?!
(Shakes head disapprovingly) Brief Introduction to NLM:
Our National Legislation Meeting
Open only to Current & Elect VPs, MC and MC Applicants
LC Take-over (VP elects taking the reins)
AND MCP & MCVP 2013-2014 Elections (YAY!)
Celebrating our success over the past year! It's a secret ;) Chillout lounge....
Present Remotely
Send the link below via email or IMCopy
Present to your audienceStart remote presentation
- Invited audience members will follow you as you navigate and present
- People invited to a presentation do not need a Prezi account
- This link expires 10 minutes after you close the presentation
- A maximum of 30 users can follow your presentation
- Learn more about this feature in our knowledge base article
Do you really want to delete this prezi?
Neither you, nor the coeditors you shared it with will be able to recover it again.
Make your likes visible on Facebook?
Connect your Facebook account to Prezi and let your likes appear on your timeline.
You can change this under Settings & Account at any time.
NLM Delegates Booklet
made with love by Phi :D
Oraianthi Toumazatouon 7 January 2013
Comments (0)
Please log in to add your comment.


text: Maintreedescendants Create or update sensor page To add new tabs: Create tab: pictures 29 52 → (Samuel Baglin (c1742-1813), 1) → (John Baglin (1773-1840), 2)→→ (George Baglin (1797-1856), 3)→→ (Eliza Baglin (c1840-1929), 4) 712348 Samuel Baglin (c1742-1813)/descendantsSamuel Baglin (c1742-1813)/infoSamuel Baglin (c1742-1813)/sensorSamuel Baglin (c1742-1813)/tree Retrieved from "http://familypedia.wikia.com/wiki/Samuel_Baglin_(c1742-1813)/sensor?oldid=436500" Ad blocker interference detected! Wikia is a free-to-use site that makes money from advertising. We have a modified experience for viewers using ad blockers Wikia is not accessible if you've made further modifications. Remove the custom ad blocker rule(s) and the page will load as expected. Category: Sensor pages


text:
OPPOSITION leader Isobel Redmond was a no show at a Liberal Party pre-selection vote for the north eastern suburbs electorate of Hartley this afternoon.
Ms Redmond has yet to make a public appearance or release a statement about yesterday's challenge to her position by Martin Hamilton-Smith.
Moderate Steven Marshall, who is contesting the deputy leadership position did appear, along with Vickie Chapman and Federal MP and education spokesman Christopher Pyne.
Mr Marshall was tight lipped but Ms Chapman wouldn't be drawn on the leadership challenge, which will be decided at a party meeting on Tuesday.
Ms Chapman said: "I won't be making any comment on leadership issues."
Former Hartley MP Joe Scalzi and Marika Ryan contested the pre-selection but Norwood, Payneham and St Peters councillor Vincent Tarzia won the ballot for the ultra-marginal seat with a comfortable lead.
After a recent distribution, Hartley is now considered Labor''s most marginal seat with just a 0.5 per cent swing needed to unseat the incumbent Education Minister Grace Portolesi.
Originally published as Redmond no-show at pre-selection vote


text:
November marks Canada's poorest monthly sales performance in 2008, as deliveries fell 10.3% compared with like-2007, according to Ward's data. Only April's 8.2% decline comes close. Last month's unit sales totaled 105,056 vs. 117,057 in like-2007. Car deliveries lagged year-ago by 11.5% during the month with double digit decreases in both midsize and large-car sales, while small-car demand remained flat. Light-truck sales fared better, slipping only 9.1% from year-ago. Lower gas prices ...
Premium Content (PAID Subscription Required)
"Slight Bump in SUV Sales Canada's Only Bright Spot in November" is part of the paid WardsAuto Premium content. You must log in with Premium credentials in order to access this article. Premium paid subscribers also gain access to:
All of WardsAuto's reliable, in-depth industry reporting and analysis
Hundreds of downloadable data tables including:
• Global sales and production data by country
• U.S. model-line inventory data
• Engine and equipment installation rates
• WardsAuto's North America Plant by Platform forecast
• Product Cycle chart
• Interrelationships among major OEMs
• Medium- and heavy-duty truck volumes
• Historical data and much more!
For WardsAuto.com pricing and subscription information please contact
Lisa Williamson by email: firstname.lastname@example.com or phone: (248) 799-2642
Current subscribers, please login or CLICK for support information.


text:
Budding athletes joined forces to take part in a fun keep fit camp.
Youngsters flocked to Gateshead Stadium during the school holidays to take part in the three day Startrack Athletics Camp. The event was organised by Gateshead Harriers.
The camp was open to all athletics enthusiasts from eight to 13, from beginners to those with experience.
It offered the chance to get a taster of various athletics disciplines such as throwing, jumping and rowing, while also promoting enjoyment of sport.
The next Startrack Athletics Camp is scheduled for the Easter school holidays. For further information or an application form, contact Gateshead International Stadium on (0191) 4335700.


text:
|Message view
|« Date » · « Thread »
|« Date » · « Thread »
|"Rob Staveley (Tom)" <rstave...@seseit.com>
|RE: Avoiding java.lang.OutOfMemoryError in an unstored field
|Tue, 06 Jun 2006 09:43:48 GMT
You are right there are going to be a lot of tokens. The entire boxy of a text document is getting indexed in an unstored field, but I don't see how I can flush a partially loaded field. -----Original Message----- From: karl wettin [mailto:email@example.com] Sent: 06 June 2006 10:33 To: firstname.lastname@example.com Subject: RE: Avoiding java.lang.OutOfMemoryError in an unstored field On Tue, 2006-06-06 at 10:22 +0100, Rob Staveley (Tom) wrote: > > Thanks for the response, Karl. I am using FSDirectory. > -X:AggressiveHeap might reduce the number of times I get bitten by the > problem, but I'm really looking for a streaming/serialised approach [I > think!], which allows me to handle objects which are larger than > available memory. Using the java.io.Reader-based constructor for the > unstored org.apache.lucene.document.Field means that I do not need to > load the untokenised content entirely into RAM, but I'm hoping that > the tokenised content of org.apache.lucene.document.Field and > org.apache.lucene.document.Document also do not need to live in RAM, > because that puts a limit on document size. The instances of Document and their Fields are only created at Hits.doc() and when you create them for insertion in the index. They live only as long as you keep track of them. Lucene keeps no references as far as I know. As I wrote in my second reply, if you run out of memory when indexing it sounds to me as you allow lots and lots of tokens per field. In this case you should look at flushing your documents more often. --------------------------------------------------------------------- To unsubscribe, e-mail: firstname.lastname@example.com For additional commands, e-mail: firstname.lastname@example.com
|View raw message


text:
- Type of feat
- Racial
- Prerequisite
- Gray Orc
- Required for
- None
- Specifics
Gray Orcs are able to take much larger strides than average humanoids, this results in a 10% movement speed bonus.
- Use
- Automatic
Gameplay NotesEdit
- This stacks with Woodland Stride, Dash, Fast movement and Monk Speed. However alignment, and multiclass restrictions prevent you from stacking them too heavily without hurting the characters spellcasting/combat skills or time it takes to level up.
- Note: A Cleric who chooses the Plant Domain and Travel Domain would get a Druid's Woodland Stride and a Barbarian's Fast Movement class feats at Cleric Level 1 and then could simultaneously gain both Cleric caster levels and Monk speed increases by becoming a Sacred Fist. For completeness, such a Cleric/Monk/Sacred Fist could also take three levels of Neverwinter Nine to get Frantic Reactions, which provides yet another 10% speed boost during battle, but it probably would be preferable to take 3 Monk levels for +10 in speed instead.


text:
Direct 3-dimensional measurement of scapular kinematics during dynamic movements in vivo
- August George
- 2 years ago
- Views:
1 Direct 3-dimensional measurement of scapular kinematics during dynamic movements in vivo Philip W. McClure, PhD, PT, a Lori A. Michener, MEd, PT, ATC, b Brian J. Sennett, MD, c and Andrew R. Karduna, PhD, d Glenside and Philadelphia, Pa, and Richmond, Va The purpose of this study was to describe 3-dimensional scapular motion patterns during dynamic shoulder movements with the use of a direct technique. Direct measurement of active scapular motion was accomplished by insertion of mm bone pins into the spine of the scapula in 8 healthy volunteers (5 men, 3 women). A small, 3- dimensional motion sensor was rigidly fixed to the scapular pins. Sensors were also attached to the thoracic spine (T3) with tape and to the humerus with a specially designed cuff. During active scapular plane elevation, the scapula upwardly rotated (mean [SD] = 50 [4.8 ]), tilted posteriorly around a medial-lateral axis (30 [13.0 ]), and externally rotated around a vertical axis (24 [12.8 ]). Lowering of the arm resulted in a reversal of these motions in a slightly different pattern. The mean ratio of glenohumeral to scapulothoracic motion was 1.7:1. Normal scapular motion consists of substantial rotations around 3 axes, not simply upward rotation. Understanding normal scapular motion may assist in the identification of abnormal motion associated with various shoulder disorders. (J Shoulder Elbow Surg 2001;10: ) Proper scapular motion and stability is considered to be crucial to normal function of the shoulder. The scapula must serve as a stable base for glenohumeral function but it also must move through a substantial arc of motion. This motion is required to maintain optimal muscle length-tension relations and glenohumeral joint alignment during elevation of the arm. Because of these demands, abnormal scapular motion has been found to From the Department of Physical Therapy, Arcadia University (formerly Beaver College), Glenside, Pa, a the Department of Physical Therapy, Medical College of Virginia, Richmond, b the Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, c and the Department of Rehabilitation Sciences, MCP-Hahnemann University, Philadelphia, Pa. d This work was partially supported by a grant from the Orthopaedic Section of the American Physical Therapy Association. Reprint requests: Philip McClure, PhD, PT, Associate Professor, Arcadia University, 450 S Easton Rd, Glenside, PA ( Copyright 2001 by Journal of Shoulder and Elbow Surgery Board of Trustees /2001/$ /1/ doi: /mse be associated with pathologies such as the impingement syndrome and glenohumeral instability. 13,17,24 Scapular motion has been studied by various methods. The classic work of Inman et al 7 in 1944 used 2- dimensional analysis of radiographs to document scapular position, as did many subsequent investigators. 5,19 Inman et al found an overall 2:1 relation between glenohumeral elevation and scapular upward rotation, which has remained the classic description of the so-called scapulohumeral rhythm. Other authors have also measured scapular motion with simple 2- dimensional goniometric methods. 4,25 Most previous 2- dimensional studies have focused on upward rotation of the scapula during scapular plane elevation. However, 2-dimensional methods fail to account for out-of-plane motions, which may produce significant errors and also may fail to capture the complexity of the movement. 3 More recent efforts have begun to identify other components of a more complex, 3-dimensional scapular motion pattern with the use of 3-dimensional radiographic, digitizing, and electromagnetic-based measurement systems. 6,11,12,14,16,18,22 The scapula has been particularly difficult to track during dynamic shoulder function. This is because digitizing and radiographic techniques require static positioning and dynamic tracking with surface markers. Use of surface markers is made difficult because of the scapula s broad, flat shape, its substantial soft-tissue covering, and the significant subcutaneous motion. The purpose of this article was to describe the direct, 3-dimensional motion of the scapula during dynamic arm motions performed in vivo under various conditions. We used a 3-dimensional electromagnetic-based system and attached a motion sensor directly to the scapula with bone pins drilled into the spine of the scapula with the patient under local anesthesia. This work is part of a larger study directed at quantifying the error associated with a noninvasive measurement technique. 9 MATERIALS AND METHODS Subjects Eight healthy volunteers (5 men, 3 women) with a mean age of 32.6 years (range 27 to 37 years) without shoulder pathologies were recruited for this study. The mean body mass index was 25.2 kg/m 2 (range 19.1 to 35.2 kg/m 2 ). All subjects were right-hand dominant, and the left shoul- 269
2 270 McClure et al J Shoulder Elbow Surg May/June 2001 Figure 1 Subject with motion sensors attached: thoracic sensor (a), scapular sensor attached to bone pins (via plastic guide) inserted into the scapula (b), and humeral sensor mounted on custom cuff applied to the distal humerus (c). The sensor mounted on the acromion (not labeled) was used for data related to another study. der was tested in 7 of the 8 subjects. Approval was obtained from the internal review board of MCP-Hahnemann University, and all subjects read and signed a consent form before participation in the study. Figure 2 Anatomic landmarks used for digitization and coordinate axes for each segment. Global: X, lateral; Y, anterior; Z, superior. Thorax: T1, first thoracic vertebrae; T7, seventh thoracic vertebrae; SN, sternal notch; Z T, vector connecting T7 to T1; X T, vector perpendicular to plane T1-T7-SN; Y T, cross product of Z T and X T. Scapula: AC, acromioclavicular joint; SP, root of scapular spine; IA, inferior angle; X S, vector connecting SP to AC; Y S, vector perpendicular to plane AC-SP-IA; Z S, cross product of X S and Y S. Humerus: HH, center of humeral head; LE, lateral epicondyle; ME, medial epicondyle; Z H, vector connecting mid point of ME and LE to HH; Y H, vector perpendicular to plane ME-LE-HH; X H, cross product of Y H and Z H. Instrumentation Rotational motion was measured with an electromagnetic tracking device (Polhemus 3Space Fastrak, Colchester, Vt). The manufacturer has reported an accuracy of 0.8 mm and 0.15 for this device, and we have verified this accuracy under controlled laboratory conditions. A global coordinate system was established by mounting the Polhemus transmitter on a rigid plastic base. The transmitter was aligned with the cardinal planes of the body by using a small jig that aligned a subject s heels along a line parallel with the transmitter (G S axis), and subjects were instructed to look straight ahead throughout testing. To ensure that the transmitter was level, the orientation was adjusted with visual feedback from a bubble level. Receivers were mounted on the thorax, humerus, and scapula. The thorax receiver was placed at the level of the third thoracic spinous process (T3) with double-sided tape. The humeral receiver was mounted on a molded cuff strapped to the distal humerus. The scapular receiver was fixed to the scapula with pins inserted under sterile conditions by an orthopaedic surgeon. A small region on the lateral scapular spine was cleaned and anesthetized with lidocaine. Two 1.6-mm bone pins then were drilled into the spine of the scapula transcortically, 1 inch apart, with the use of a plastic alignment jig to keep them parallel. After determining that the pins were secure in the bone, they were fixed to the alignment jig with setscrews. The scapula receiver was then secured to this jig for ideal coupling between scapula and receiver (Figure 1). Kinematics The arbitrary axes defined by the Polhemus were converted to anatomically appropriate embedded axes, which were derived from digitized bony landmarks (Figure 2). An embedded axis system is a means of achieving an anatomically meaningful axis system within each specific bone being studied. The bony landmarks chosen to define each bone are similar to those in previous studies. 12,16 All bony landmarks were surface points and thus could be located with a digitizer connected to the Polhemus, except for the center of the humeral head. This was defined as the point on the humerus that moved the least when the humerus was moved through short arcs (<45 ) of midrange glenohumeral motion and was calculated with use of a least-squares algorithm. 20 Motion of the humerus with respect to the thorax was represented with a standard Euler angle sequence in which the first rotation defined the plane of elevation, the second rotation described the amount of elevation, and the last rotation represented the amount of internal/external rotation. 1,8 Rota-
3 J Shoulder Elbow Surg Volume 10, Number 3 McClure et al 271 A D B E C Figure 3 Scapular and clavicular rotations during active scapular plane abduction (mean ± SEM). A, Scapular posterior tilting; B, scapular upward rotation; C, scapular external rotation; D, clavicular plane rotation; E, clavicular elevation. Because subjects varied in total range of humerothoracic motion, the minimum and maximum points represent the average of the 8 subjects., Raising the arm;, lowering the arm; deg, degrees. tional motion of the scapula with respect to the thorax was described on the basis of a Euler angle sequence of external/internal rotation (Z S axis), upward/downward rotation (Y S axis), and posterior/anterior tilting (X S axis). 21,22 The position of the scapula was represented by the rotational motion of the clavicle. The scapula is connected to the thorax by means of the sternoclavicular and acromioclavicular joints, both of which are assumed to exhibit balland-socket kinematics, which implies that only rotation and no translation occurs at these joints. Consequently, the orientation of the scapula with respect to the thorax has 3 degrees of freedom and can be represented by the 3 Euler angles described above. However, because of the rigidity of the clavicle, which spans these 2 joints, the distance between them is kept constant. Therefore, the position of the scapula is restricted to only 2 degrees of freedom and can be represented by the rotational motion of the clavicle: retraction/protraction and elevation. This is equivalent to describing the position of a point on the Earth with the use of 2 angles: longitude and latitude. Clavicular motion was not monitored directly, but rather, clavicular angles were derived from the location of the sternal notch and the acromioclavicular joint, which were tracked with the thoracic and scapular receivers, respectively. Experimental protocol After the digitization process, the raw data from the 3 receivers were converted to anatomically defined rotations that could be displayed in real time in LabView (National Instruments, Austin, Tex). Subjects stood with their eyes fixed forward, feet at a comfortable width apart, and heels against a rigid support. A total of 3 active motions were studied: (1) scapular plane elevation: elevation of the humerus in the scapular plane (40 anterior to the frontal
4 272 McClure et al J Shoulder Elbow Surg May/June 2001 A D B E C Figure 4 Scapular and clavicular rotations during active sagittal plane flexion (mean ± SEM). A, Scapular posterior tilting; B, scapular upward rotation; C, scapular external rotation; D, clavicular plane rotation; E, clavicular elevation. Because subjects varied in total range of humerothoracic motion, the minimum and maximum points represent the average of the 8 subjects., Raising the arm;, lowering the arm; deg, degrees. plane) with the elbow in full extension and thumb pointing up, (2) flexion: elevation of the humerus in the sagittal plane (90 anterior to the frontal plane) with the elbow in full extension and the thumb pointing up, and (3) internalto-external rotation with the arm elevated 90 in the frontal plane and the elbow flexed to 90. The starting position for scapular plane elevation and flexion was with the arm by the side with the palm against the thigh. Subjects were asked to refrain from watching their arms or the computer screen during the motion. For scapular plane elevation and flexion, a series of practice trials were performed in which the investigator monitored the plane of elevation on the computer and provided the subject with verbal feedback. Once the subject could accurately reproduce the correct motion (correct plane of elevation maintained within ±5 ), data collection began. For internal/external rotation, the investigator monitored arm position so that the 90 elevation position was maintained. For each motion, subjects moved their arm maximally through the range to a count of 3 and then returned along the same path, with data collected continuously at a rate of approximately 10 Hz. This procedure was repeated for 3 consecutive trials. For each trial, the minimum and maximum elevation points were calculated, and the rest of the data were linearly interpolated in 5 increments of humerothoracic motion. These data were averaged over the 3 trials. For each arm motion we assessed separately the phases in which the humeral angle was increasing (elevation or external rotation) and decreasing (lowering or internal rotation). To describe motion for the group, the interpolated data from all subjects were pooled, and a single curve for each particular arm motion and scapular or clavicular rotation was plotted.
5 J Shoulder Elbow Surg Volume 10, Number 3 McClure et al 273 A D B E C Figure 5 Scapular and clavicular rotations during humeral external/internal rotation with the arm abducted 90 in the coronal plane (mean ± SEM). A, Scapular posterior tilting; B, scapular upward rotation; C, scapular external rotation; D, clavicular plane rotation; E, clavicular elevation. Because subjects varied in total range of humerothoracic motion, the minimum and maximum points represent the average of the 8 subjects., Moving from internal to external rotation;, moving from external to internal rotation; deg, degrees. RESULTS During scapular plane elevation of the arm, there was a consistent pattern of scapular upward rotation, posterior tilting, and external rotation along with clavicular elevation and retraction (Figure 3). Upward rotation of the scapula and clavicular rotation occurred approximately linearly throughout humeral elevation, especially beyond 50 of elevation. Posterior tilting and external rotation motions were nonlinear, with the majority of these motions not occurring until after 90 of arm elevation. The results of sagittal plane elevation (flexion) are shown in Figure 4 and do not differ substantially from the motions observed during scapular plane elevation. For external/internal humeral rotation, relatively little scapular rotation occurred except at the end-range of external rotation (Figure 5). As full humeral external rotation was achieved, the scapula upwardly rotated, tilted posteriorly, and externally rotated while the clavicle retracted. Although the path of motion during the lowering phase of the activity was slightly different in some cases, mean scapular orientation during lowering was typically within 5 compared with the elevation phase of the activity. For both scapular plane elevation and flexion, the greatest differences between the two phases occurred in scapular upward rotation during the mid range between approximately 60 and 120. During humeral external/internal rotation, the greatest differences between the phases seemed to occur in scapular
6 274 McClure et al J Shoulder Elbow Surg May/June 2001 A B Figure 6 Humeral external rotation relative to the thorax during arm elevation. A, Scapular plane elevation; B, sagittal plane flexion. deg, Degrees. tilting and upward rotation between 30 and 60 of humeral external rotation. The amount of humeral external rotation during elevation was not constrained and could have influenced scapular motion. This motion is depicted for all subjects in Figure 6. These graphs show that the humerus externally rotated during scapular plane elevation sooner and to a greater extent than during flexion. DISCUSSION Comparing data across studies is difficult because of several important methodologic differences. These differences include the specific arm motion studied (ie, the plane of elevation and the specific range of motion studied), static versus dynamic motion, trunk position and the degree of stabilization, the type and number of subjects, and differing measurement techniques. Aside from the different instruments used to obtain measurements, many other factors affect the results when scapular motion is studied. These include the choice of bony landmarks used to create local coordinate frames, the method used to calculate angles and describe motion (ie, planar projections, Euler angles, helical axis), choice of a fixed reference frame (ie, various thoracic definitions or a global system that uses pure vertical and horizontal references), and the specific methods used to reduce and present the data, such as whether the resting position is taken as zero or is given a value on the basis of a defined anatomic zero position. Also, various ratios have been used to characterize motion and scapulohumeral rhythm. Given these differences, it is not surprising that variation exists in the literature relating to scapular kinematics. Despite the above concerns, we attempted to compare our findings with those of previous studies (See Table).* Scapular upward rotation has been the most extensively studied motion, and previous authors report values above and below those found in this study. A *References 2, 4, 7, 8, 11, 12, 16, 19, 22. common method of assessing upward rotation has been to characterize the ratio of glenohumeral motion to scapulothoracic upward rotation motion (GH/ST). The GH/ST for the pooled data in our study was 2.0 for flexion and 1.7 for scapular plane elevation. Various GH/ST ratios have been obtained previously by other authors ranging from to under similar conditions. This ratio can be affected by the method used to measure humeral motion. Most studies seem to assume a 0 starting position of the humerus, whereas some others actually measure the rest position, which is typically greater than zero. If we assume a 0 starting position for humeral elevation with our data, the GH/ST ratios become 2.3 and 1.9 for flexion and scapular plane abduction, respectively. The relation between scapular upward rotation and humeral elevation has been generally acknowledged to be nonlinear. To characterize this relation, we performed both linear and polynomial curve fits on the mean data for the ascending phase of scapular plane abduction, as shown in Figure 7. The R 2 value was for the linear fit, which would suggest a strong linear relation. However, visual inspection of a linearcurve fit reveals substantial error at the beginning and end of the motion, as is shown in Figure 7. During the first 30 of humerothoracic elevation, the scapula moves very little; whereas at the extreme of elevation, the rate of scapular upward rotation increases compared with the middle range of elevation. The R 2 value for a third order polynomial fit (Figure 7) was 0.999, suggesting a nonlinear relation. Interestingly, the lowering phase demonstrated a much more linear relation (R 2 = 0.997). The significance of this difference is unclear; however, we speculate that greater eccentric neuromuscular control may be exerted on the scapula during the lowering phase of elevation and may be responsible for the slightly different pattern. Posterior tilting motion has been a less recognized
7 J Shoulder Elbow Surg Volume 10, Number 3 McClure et al 275 Table Scapular rotations measured by various authors Author Method Range of arm motion Mean scapular motion Inman et al, * 2D radiographs Flexion Upward rotation (estimated from graphs) 25 Clavicle elevation 30 Clavicle posterior rotation FP abd Upward rotation 30 Clavicle elevation 30 Clavicle posterior rotation Doody et al, * 2D goniometry SP abd Upward rotation Poppen and Walker, (estimated 2D radiographs SP abd Upward rotation from regression equation) 40 Posterior tilt ( twisting ) Kondo et al, * 3D double radiograph SP abd 0 -max 60 Upward rotation 24 Posterior tilt 8 Int rotation ( medial tilt ) Bagg and Forrest, D photographic SP abd Upward rotation Johnson et al, (mean of 2 testers)* 3D electromagnetic FP abd Upward rotation digitizer (static) 9 Posterior tilt 6 Int rotation ( protaction ) McQuade et al, D electromagnetic SP abd Upward rotation digitizer (static) 31 Posterior tilt 67 Int rotation van der Helm and Pronk, (estimated 3D electromechanical Flexion Upward rotation from graphs)* digitizer (static) 30 Posterior tilt 25 Int rotation ( retraction ) 22 Clavicle protraction 10 Clavicle elevation FP abd Upward rotation 30 Posterior tilt 25 Int rotation ( retraction ) 22 Clavicle protraction 10 Clavicle elevation Ludewig et al, * 3D electromechanical SP abd Upward rotation digitizer (static) 15 Posterior tilt 13 Int rotation Meskers et al, (values estimated 3D electromagnetic Flexion Upward rotation from graphs)* digitizer (quasi-static) 24 Posterior tilt 0 Int rotation ( protraction ) FP abd Upward rotation 13 Posterior tilt 3 Int rotation ( protraction ) Current study (McClure et al)* 3D electromagnetic Flexion Upward rotation continuous tracking 31 Posterior tilt 26 Int rotation 20 Clavicle protraction 9 Clavicle elevation SP abd Upward rotation 30 Posterior tilt 24 Int rotation 21 Clavicle protraction 10 Clavicle elevation 2D, Two-dimensional; FP abd, frontal plane abduction; SP abd, scapular plane abduction; 3D, 3-dimensional; max, maximum; int, internal. *Values represent total excursion = maximal elevation rest position. Uncertain whether these values represent total excursion or absolute position at maximal elevation. Uncertain whether these values represent posterior or anterior tilting. Uncertain whether these values represent internal or external rotation. aspect of scapular motion during humeral elevation. As shown in the Table, there is wide disparity in the literature as to the amount of tilting that occurs. Unfortunately, some previous studies have not clearly identified the direction of tilting, 8,16 which makes comparison more difficult. The motion pattern was clearly nonlinear, and the majority of tilting motion occurred beyond 90 of elevation, with a very sharp increase at end range. As evidenced by the small standard errors, this motion was quite consistent among the 8 subjects. The presence of posterior tilting may be important functionally to allow for clearance of the humeral head and the rotator cuff tendons under the anterior aspect of the acromion during elevation. In previous work, we iden-
8 276 McClure et al J Shoulder Elbow Surg May/June 2001 Figure 7 Scapular upward rotation during humeral elevation in the scapular plane. Raising the arm is best represented by the third-order polynomial curve fit, which demonstrates the nonlinear aspect of the relation. Lowering the arm is represented well by a linear fit., Raising the arm;, lowering the arm; deg, degrees. tified this motion as a potentially important discriminator between asymptomatic subjects and subjects with impingement syndrome. 13 Subjects with impingement had approximately 10 less posterior tilting compared with asymptomatic subjects. We found substantially more scapular external rotation during humeral elevation than has been reported previously. 8,11,12,16,22 Similar to the results of posterior tilting, the motion pattern was obviously nonlinear, with the majority of motion occurring beyond 90 elevation and increasing most dramatically at end range. Interestingly, some authors report internal rotation (sometimes termed protraction) during elevation, as opposed to our consistent finding of external rotation. 8,11,16 This may represent an inherent problem in palpation-based tracking techniques in which bony landmarks must be followed with a locating device. The functional significance of scapular external rotation motion is unclear. We speculate that external rotation of the scapula may lessen the requirement for glenohumeral external rotation as the arm is fully elevated. If this scapular motion is lacking, it is possible that greater motion demands would be placed on the glenohumeral joint, which could lead to capsular laxity and anterior instability. This motion may also be influenced by the contour of the ribs. Rotations of the clavicle in 2 different planes (clavicular plane and clavicular elevation) were chosen to describe the position of the scapula during motion because the scapula is constrained by the clavicle. During humeral elevation, the clavicle retracted approximately 20, indicating posterior movement of the scapula. This motion was greatest from 130 to 150 of humeral elevation, and it did not really begin until approximately 25 of scapular plane elevation and about 50 of flexion. The clavicle elevated a total of approximately 10 during humeral elevation, indicating superior movement of the scapula. We did not track the clavicle directly with bone pins. Inman et al 7 reported approximately 30 of clavicular elevation during humeral elevation and stated that most of the motion occurred by 90 of humeral elevation. It is unclear what method they used to measure clavicular elevation, though it appears radiographs were used. They did insert pins directly in the clavicle of a subject to assess clavicular rotation about its long axis and found approximately 40 of posterior rotation, which occurred mostly after 90 of humeral elevation, yielding a nonlinear curve. We were unable to measure clavicular rotation about its long axis; however, it seems likely that posterior tilting of the scapula may be related to this motion. As the coracoclavicular ligaments become tightened, the clavicle rotates posteriorly, which is probably coupled with posterior scapular tilting. External and internal rotation of the humerus with the arm abducted 90 in the frontal plane also produced substantial scapular motion. As the humerus approached the extreme of external rotation, the scapula underwent rather abrupt posterior tilting, upward rotation, and external rotation. However, relatively limited scapular motion occurred in the mid ranges of rotation. Although attempts were made to maintain the humerus in 90 abduction, humeral elevation varied between 75 to 95 during the test movements. Humeral external rotation was associated with greater humeral elevation, which may have influenced scapular motion. The scapular motions appear to be important in attaining the end-range positions of humeral rotation. A lack of scapular motion may produce greater stress on the glenohumeral joint capsule and potentially lead to overstretching and laxity. To our knowledge, only one other study has directly measured scapular motion 3-dimensionally during continuous motion: Koh and colleagues 10 inserted pins in both the scapula and humerus in 3 subjects and tracked the motion during humeral elevation in 3 different planes with the use of a video-based system. Their results are somewhat difficult to interpret and compare with previous work because they present the data with helical axis parameters. Their principal finding was that the scapula rotated primarily around an axis perpendicular to the plane of the scapula. The precise mechanisms controlling scapular motion are not well understood. Certainly, muscle action is partially responsible for scapular control, and muscle fatigue 15 as well as shoulder strengthening have both been shown to alter the GH/ST ratio. 23 Passive mechanisms may also control scapular motion, such as capsular tightness or laxity, and tension in the coracoclavicular ligaments. Both posterior tilting and external rotation of the scapula increased dramatically as the arm was raised above 90. It may be that as the glenohumeral joint reaches its limits of motion, the capsular tension generated may pull the scapula along as the arm elevates.
9 J Shoulder Elbow Surg Volume 10, Number 3 McClure et al 277 Knowledge of normal scapular motion and the factors that control it could serve as the basis for understanding several pathologies thought to be related to abnormal scapular control, such as impingement syndrome and glenohumeral instability. 13,24 If active muscle control is important, this would support specific rehabilitative exercises designed to strengthen muscles and improve motor control. If passive mechanisms provided by capsular and ligamentous support prove to be important, injuries and interventions designed to alter these factors could be better understood. Our future work will be directed at elucidating the basic mechanisms controlling scapular motion and studying the effects of various pathologies and treatment methods. Because of the invasive nature of this study, we used a relatively small sample of young, asymptomatic adults, most of whom preferred to have their nondominant, left shoulder girdle tested. Therefore caution must be used in extrapolating these findings to a broader population. No subject complained of pain during the experiment, and the instrumentation was very lightweight and unobtrusive. However, it is possible that the pins and instrumentation may have affected the motion in some way. Also, the motions tested were performed at relatively slow speeds (approximately 30 to 50 per second) in a controlled manner, and functional tasks performed at high velocities may produce different motion patterns. REFERENCES 1. An KN, Browne AO, Korinek S, Tanaka S, Morrey BF. Threedimensional kinematics of glenohumeral elevation. J Orthop Res 1991;9: Bagg SD, Forrest WJ. A biomechanical analysis of scapular rotation during arm abduction in the scapular plane. Am J Phys Med Rehabil 1988;67: de Groot JH. The scapulo-humeral rhythm: effects of 2-D roentgen projection. Clin Biomech (Bristol, Avon) 1999;14: Doody SG, Freedman L, Waterland JC. Shoulder movements during abduction in the scapular plane. Arch Phys Med Rehabil 1970;51: Freedman L, Munro RR. Abduction of the arm in the scapular plane: scapular and glenohumeral movements. J Bone Joint Surg Am 1966;48: Högfors C, Peterson B, Sigholm G, Herberts P. Biomechanical model of the human shoulder: II. The shoulder rhythm. J Biomech 1991;24: Inman VT, Saunders M, Abbott LC. Observations on the function of the shoulder joint. J Bone Joint Surg Am 1944;26: Johnson GR, Stuart PR, Mitchell S. A method for the measurement of three-dimensional scapular movement. Clin Biomech 1993;8: Karduna AR, McClure PW, Michener LA, Sennett BJ. Validation of a novel method for measuring dynamic three-dimensional scapular kinematics. J Biomech Eng. In press. 10. Koh T, Grabiner M, Brems J. Three-dimensional in vivo kinematics of the shoulder during humeral elevation. J Appl Biomech 1998;14: Kondo M, Tazoe S, Yamada M. Changes of the tilting angle of the scapula following elevation of the arm. In: Bateman JE, Welsh RP, editors. Surgery of the shoulder. Philadelphia: BC Decker, Inc; p Ludewig PM, Cook TM, Nawoczenski DA. Three-dimensional scapular orientation and muscle activity at selected positions of humeral elevation. J Orthop Sports Phys Ther 1996;24: Lukasiewicz A, McClure P, Michener L, Pratt N, Sennett B. Comparison of three-dimensional scapular position and orientation between subjects with and without shoulder impingement syndrome. J Orthop Sports Phys Ther 1999;29: McQuade KJ, Smidt GL. Dynamic scapulohumeral rhythm: the effects of external resistance during elevation of the arm in the scapular plane. J Orthop Sports Phys Ther 1998;27: McQuade KJ, Wei SH, Smidt GL. Effects of local muscle fatigue on three-dimensional scapulohumeral rhythm. Clin Biomech 1995;10: Meskers CGM, Vermeulen HM, de Groot JH, van der Helm FCT, Rozing PM. 3D shoulder position measurements using a six-degree-of-freedom electromagnetic tracking device. Clin Biomech 1998;13: Paletta GA, Warner JJP, Warren RF, Deutsch A, Altchek DW. Shoulder kinematics with 2-plane x-ray evaluation in patients with anterior instability or rotator cuff tearing. J Shoulder Elbow Surg 1997;6: Pearl ML, Jackins S, Lippitt SB, Sidles JA, Matsen FA III. Humeroscapular positions in a shoulder range-of-motion-examination. J Shoulder Elbow Surg 1992;1: Poppen NK, Walker PS. Normal and abnormal motion of the shoulder. J Bone Joint Surg Am 1976;58: Sidles JA, Garbini JL, Matsen FA III. A general-purpose system for joint kinematic measurements. In: Torzilli PA, editor Biomechanics Symposium, La Jolla, Calif; 1989 Jul p van der Helm FCT. A standardized protocol for motion recordings of the shoulder. In: Veeger HEJ, van der Helm FCT, editors. First Conference of the International Shoulder Group. Delft, The Netherlands; 1997 Aug p van der Helm FCT, Pronk GM. Three-dimensional recording and description of motions of the shoulder mechanism. J Biomech Eng 1995;117: Wang CH, McClure PW, Pratt NE. Stretching and strengthening exercises: their effect on three-dimensional scapular kinematics. Arch Phys Med Rehabil 1999;80: Warner JJP, Micheli LJ, Arslanian LE, Kennedy J, Kennedy R. Scapulothoracic motion in normal shoulders and shoulders with glenohumeral instability and impingement syndrome. Clin Orthop 1992;285: Youdas JW, Carey JR, Garrett TR, Suman VJ. Reliability of goniometric measurements of active arm elevation in the scapula plane obtained in a clinical setting. Arch Phys Med Rehabil 1994;75:
The Shoulder Complex & Shoulder Girdle
The Shoulder Complex & Shoulder Girdle The shoulder complex 4 articulations involving The sternum The clavicle The ribs The scapula and The humerus Bony Landmarks provide attachment points for musclesMore information
Clarification of Terms
Shoulder Girdle Clarification of Terms Shoulder girdle = scapula and clavicle Shoulder joint (glenohumeral joint) = scapula and humerus What is the purpose (or function) of the shoulder and entire upperMore information
Shoulder Biomechanics. Lecture originally developed by Bryan Morrison, Ph.D. candidate Arizona State University Fall 2000
Shoulder Biomechanics Lecture originally developed by Bryan Morrison, Ph.D. candidate Arizona State University Fall 2000 1 Outline Anatomy Biomechanics Problems 2 Shoulder Complex Greatest Greatest PredispositionMore information
Knowledge of the normal
Three-Dimensional Clavicular Motion During Arm Elevation: Reliability and Descriptive Data Paula M. Ludewig, PT, PhD 1 Stacy A. Behrens, PT, MS 2 Susan M. Meyer, PT, MS 3 Shawn M. Spoden, PT, MS 4 LauraMore information
Movements. Shoulder Anatomy and Biomechanics. Five Functional Joints. Sternoclavicular Joint. Sternoclavicular Joint. Sternoclavicular Joint
Shoulder Anatomy and Biomechanics Movements Sagital plane Flexion (180 ) Extension (60 ) Coronal plane Abduction (180 ) Transverse plane Internal rotation (80 ) External rotation (90 ) Horizontal abductionMore information
Calibration of the &&Flock of Birds'' electromagnetic tracking device and its application in shoulder motion studies
Journal of Biomechanics 32 (1999) 629}633 Technical Note Calibration of the &&Flock of Birds'' electromagnetic tracking device and its application in shoulder motion studies C.G.M. Meskers, *, H. Fraterman,More information
Chapter 4 The Shoulder Girdle
Chapter 4 The Shoulder Girdle Key Manubrium Clavicle Coracoidprocess Acromionprocess bony landmarks Glenoid fossa Bones Lateral Inferior Medial border angle McGraw-Hill Higher Education. All rights reserved.More information
EDNF 2012 CONFERENCE LIVING WITH EDS SHOULDER INSTABILITY IN PATIENTS WITH EDS Keith Kenter, MD Associate Professor Sports Medicine & Shoulder Reconstruction Director, Orthopaedic Residency Program DepartmentMore information
Chapter 5. The Shoulder Joint. The Shoulder Joint. Bones. Bones. Bones
Copyright The McGraw-Hill Companies, Inc. Reprinted by permission. Chapter 5 The Shoulder Joint Structural Kinesiology R.T. Floyd, Ed.D, ATC, CSCS Structural Kinesiology The Shoulder Joint 5-1 The ShoulderMore information
Overhead Strength Training for the Shoulder: Guidelines for Injury Prevention and Performance Training Success
Overhead Strength Training for the Shoulder: Guidelines for Injury Prevention and Performance Training Success Robert Panariello MS, PT, ATC, CSCS Strength training is an important component in the overallMore information
The Throwing Athlete Biomechanics Function & Dysfunction
The Throwing Athlete Biomechanics Function & Dysfunction R. Scott Cook, DO, FAOASM Director, St. Joseph Sports Medicine Fellowship Commonwealth Orthopaedic Associates Presentation Goals! Provide an understandingMore information
Journal of Biomechanics
Journal of Biomechanics ] (]]]]) ]]] ]]] Contents lists available at SciVerse ScienceDirect Journal of Biomechanics journal homepage: www.elsevier.com/locate/jbiomech www.jbiomech.com Validation of a video-basedMore information
Rehabilitation Guidelines For SLAP Lesion Repair
Rehabilitation Guidelines For SLAP Lesion Repair The anatomic configuration of the shoulder joint (glenohumeral joint) is often compared to a golf ball on a tee. This is because the articular surface ofMore information
Biomechanics of the Shoulder and Throwing
Biomechanics of the Shoulder and Throwing Shoulder Anatomy Most mobile joint in the body Ball-and-socket joint 3 bones connected by muscles, ligaments & tendons Clavicle Humerus Scapula Range of MotionMore information
Basic Biomechanics. What is Kinesiology? Why do we need Kinesiology? the body as a living machine for locomotion
Basic Biomechanics the body as a living machine for locomotion What is Kinesiology? Kinesis: To move -ology: to study: The study of movement What the heck does that mean? Why do we need Kinesiology? AsMore information
Rehabilitation Guidelines for Shoulder Arthroscopy
Rehabilitation Guidelines for Shoulder Arthroscopy Front View Long head of bicep Acromion Figure 1 Shoulder anatomy Supraspinatus Image Copyright 2010 UW Health Sports Medicine Center. Short head of bicepMore information
Terminology of Human Walking From North American Society for Gait and Human Movement 1993 and AAOP Gait Society 1994
Gait Cycle: The period of time from one event (usually initial contact) of one foot to the following occurrence of the same event with the same foot. Abbreviated GC. Gait Stride: The distance from initialMore information
Shoulder Instability. Fig 1: Intact labrum and biceps tendon
Shoulder Instability What is it? The shoulder joint is a ball and socket joint, with the humeral head (upper arm bone) as the ball and the glenoid as the socket. The glenoid (socket) is a shallow boneMore information
THE SHOULDER JOINT T H E G L E N O H U M E R A L ( G H ) J O I N T CLARIFICATION OF TERMS Shoulder girdle = scapula and clavicle Shoulder joint (glenohumeral joint) = scapula and humerus Lippert, p115More information
Effect of external load on scapular upward rotation during arm elevation: the knot concept
Madokoro et al. Journal of Experimental Orthopaedics (2016) 3:8 DOI 10.1186/s40634-016-0044-6 RESEARCH Open Access Effect of external load on scapular upward rotation during arm elevation: the knot conceptMore information
ACL plastik, erfarenheter av. tidig kirurgisk behandling. tidig kirurgisk behandling 6/12/2013
in sports Per Renström, MD, PhD Professor emeritus,,, Sweden Member ATP and ITF Sports Science and Medical Committees Physician Swedish Football Association Presentation at the IOC Advanced team physicianMore information
Overhead Throwing: A Strength & Conditioning Approach to Preventative Injury
By: Michael E. Bewley, MA, CSCS, C-SPN, USAW-I, President, Optimal Nutrition Systems Strength & Conditioning Coach for Basketball Sports Nutritionist for Basketball University of Dayton Overhead Throwing:More information
Muscular Force and Biomechanical Implications
Page 1 of 6 Biomechanics Muscular Force and Biomechanical Implications William L. Cornelius, Ph.D. Associate Professor of Education University of North Texas Understanding basic concepts of biomechanicsMore information
SCAPULAR FRACTURES. Jai Relwani, Shoulder Fellow, Reading Shoulder Unit, Reading.
SCAPULAR FRACTURES Jai Relwani, Shoulder Fellow, Reading Shoulder Unit, Reading. Aims Anatomy Incidence/Importance Mechanism Classification Principles of treatment Specific variations Conclusion AnatomyMore information
Biceps Tenodesis Protocol
Department of Rehabilitation Services Physical Therapy The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergoneMore information
IMPINGEMENT REVISITED. W. Ben Kibler, MD. From what angle are you looking at impingement -WHAT IS IT - EVALUATION - TREATMENT GUIDES
IMPINGEMENT REVISITED -WHAT IS IT - EVALUATION - TREATMENT GUIDES W. Ben Kibler, MD Medical director From what angle are you looking at impingement Bone spur- Acromion type 1, 2, 3 Rotator cuff injuryMore information
Rotator Cuff Repair Protocol
Rotator Cuff Repair Protocol Anatomy and Biomechanics The shoulder is a wonderfully complex joint that is made up of the ball and socket connection between the humerus (ball) and the glenoid portion ofMore information
Rehabilitation Guidelines for Posterior Shoulder Reconstruction with or without Labral Repair
Rehabilitation Guidelines for Posterior Shoulder Reconstruction with or without Labral Repair The anatomic configuration of the shoulder joint (glenohumeral joint) is often compared to a golf ball on aMore information
UPPER EXTREMITY INJURIES. Recognizing common injuries to the upper extremity
UPPER EXTREMITY INJURIES Recognizing common injuries to the upper extremity ANATOMY BONES Clavicle Scapula Spine of the scapula Acromion process Glenoid fossa/cavity Humerus Epicondyles ANATOMY BONES UlnaMore information
The Sw S immers immer Shoulder Katie Foster BSc. Sport, BSc. Phy Ph s y iother s apy iother, apy MMT. MMT
The Swimmers Shoulder Katie Foster BSc. Sport, BSc. Physiotherapy, MMT. Overview Anatomy Swimming and the shoulder Posture Impingement Causes and progressions Treatment Prevention The shoulder The shoulderMore information
Rehabilitation Guidelines for Anterior Shoulder Reconstruction with Arthroscopic Bankart Repair
Rehabilitation Guidelines for Anterior Shoulder Reconstruction with Arthroscopic Bankart Repair The anatomic configuration of the shoulder joint (glenohumeral joint) is often compared to a golf ball onMore information
Bringing Back the Shoulders
Bringing Back the Shoulders Mike Kamal Peak performance in competition should always be the primary goal of training. The unfortunate and sometimes unavoidable consequences of sport are fatigue, breakdownMore information
Rehabilitation Protocol: SLAP Superior Labral Lesion Anterior to Posterior
Rehabilitation Protocol: SLAP Superior Labral Lesion Anterior to Posterior Department of Orthopaedic Surgery Lahey Hospital & Medical Center, Burlington 781-744-8650 Lahey Outpatient Center, LexingtonMore information
Musculoskeletal Ultrasound Technical Guidelines. I. Shoulder
European Society of MusculoSkeletal Radiology Musculoskeletal Ultrasound Technical Guidelines I. Shoulder Ian Beggs, UK Stefano Bianchi, Switzerland Angel Bueno, Spain Michel Cohen, France Michel Court-Payen,More information
Structure and Function of the Bones and Noncontractile Elements of the Knee
Structure and Function of the Bones and Noncontractile Elements of the Knee BONES OF THE KNEE JOINT Shaft and Distal Femur Linea aspera gives rise to quadriceps. Flatten into supracondylar ridges End inMore information
FRACTURES OF THE SCAPULA Dr. Andreas Panagopoulos, MD, Ph.D. Consultant in Orthopaedic Surgery & Sports Medicine Olympion General Hospital, Patras, GR www.orthodoctor.gr Epidemiology 1% of all orthopaedicMore information
Biceps Tenotomy Protocol
Department of Rehabilitation Services Physical Therapy The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergoneMore information
9/13/2013 CLINICAL EXAM OF THE SCAPULA RATIONALE AND TECHNIQUES. W. Ben Kibler, MD. Medical director
CLINICAL EXAM OF THE SCAPULA RATIONALE AND TECHNIQUES W. Ben Kibler, MD Medical director 1 SCAPULAR DYSKINESIS ALTERATION (DYS)- POSITION, MOTION (KINESIS) Scapular dyskinesis Commonly (67-100%) seen inMore information
Rehabilitation Guidelines for Arthroscopic Capsular Shift
Rehabilitation Guidelines for Arthroscopic Capsular Shift The anatomic configuration of the shoulder joint (glenohumeral joint) is often compared to a golf ball on a tee. This is because the articularMore information
Rotator Cuff and Shoulder Conditioning Program. Purpose of Program
Prepared for: Prepared by: OrthoInfo Purpose of Program After an injury or surgery, an exercise conditioning program will help you return to daily activities and enjoy a more active, healthy lifestyle.More information
Biomechanical Analysis of the Deadlift (aka Spinal Mechanics for Lifters) Tony Leyland
Biomechanical Analysis of the Deadlift (aka Spinal Mechanics for Lifters) Tony Leyland Mechanical terminology The three directions in which forces are applied to human tissues are compression, tension,More information
6/6/2011. Unraveling the Mystery of Shoulder Pain #4: Adhesive Capsulitis (Frozen Shoulder)
Unraveling the Mystery of Shoulder Pain #4: Adhesive Capsulitis (Frozen Shoulder) Instructor: Ben Benjamin, Ph.D. 1 Instructor: Ben Benjamin, Ph.D. firstname.lastname@example.com Webinar Goal Explore the assessmentMore information
Manua l Therapy Technique s f or t he Shoulder. LCD R Joe Strunc e PT, DSc, OCS, FAAOMPT
Manua l Therapy Technique s f or t he Shoulder LCD R Joe Strunc e PT, DSc, OCS, FAAOMPT Shoulde r Techniques GH Physiological Mvmts Flexion (Grade 4) Abduction (Grade 4) External Rotation (Grade 4) InternalMore information
Reverse Total Shoulder Replacement
SPORTS & ORTHOPAEDIC SPECIALISTS Reverse Total Shoulder Replacement 6-10 Visits over 4 months Reverse Total Shoulder Replacements are especially susceptible to dislocation during internal rotation, glenohumeralMore information
Shoulder Trauma (Fractures and Dislocations)
Shoulder Trauma (Fractures and Dislocations) Trauma to the shoulder is common. Injuries range from a separated shoulder resulting from a fall onto the shoulder to a high-speed car accident that fracturesMore information
Shoulder MRI for Rotator Cuff Tears. Conor Kleweno,, Harvard Medical School Year III Gillian Lieberman, MD
Shoulder MRI for Rotator Cuff Tears Conor Kleweno,, Harvard Medical School Year III Goals of Presentation Shoulder anatomy Function of rotator cuff MRI approach to diagnose cuff tear Anatomy on MRI imagesMore information
Pattern Characterization of Running and Cutting Maneuvers in Relation to Noncontact
Pattern Characterization of Running and Cutting Maneuvers in Relation to Noncontact ACL Injury Brenna Hearn During running and cutting maneuvers, the anterior cruciate ligament (ACL) is commonly injuredMore information
Total Knee Arthroplasty. TKA - Indications. Technical Goals - TKA. Prosthesis parallel to Floor/Stance. Mechanical Axis/Center of Joint
Total Knee Arthroplasty TKA - Indications Osteoarthritis Rheumatoid Arthritis Post Traumatic Arthritis Osteonecrosis Tumor Technical Goals - TKA Prosthesis parallel to Floor/Stance Mechanical Axis/CenterMore information
Structure and Function of the Hip
Structure and Function of the Hip Objectives Identify the bones and bony landmarks of the hip and pelvis Identify and describe the supporting structures of the hip joint Describe the kinematics of theMore information
Open Rotator Cuff Repair Rehabilitation Program Methodist Sports Medicine Center, Indianapolis, IN Department of Physical Therapy
Open Rotator Cuff Repair Rehabilitation Program Methodist Sports Medicine Center, Indianapolis, IN Department of Physical Therapy Rotator Cuff Repair is a surgical procedure utilized for a tear in theMore information
Impingement series what and why?
SHOULDER Impingement series what and why? ANATOMY Bony elements of the shoulder include Humerus Scapula Clavicle http://www.frozenshoulder.ca/anatomyimages/bones3.jpg ROTATOR CUFF Supraspinatus InfraspinatusMore information
The Hemiparetic Shoulder Handle with care. Sara Gawned Senior Physiotherapist St George s Hospital October 2009
The Hemiparetic Shoulder Handle with care Sara Gawned Senior Physiotherapist St George s Hospital October 2009 Learning Objectives To have a good understanding of the anatomy around the shoulder jointMore information
SHOULDER INJURIES Overuse Injuries
SHOULDER INJURIES Overuse Injuries Michael Petrizzi, MD, CAQ 12 Shoulder : Overuse Injuries Michael J. Petrizzi, MD Clinical Professor of Family Medicine Virginia Commonwealth University Richmond, VirginiaMore information
Reverse Total Shoulder Protocol
Marion Herring, M.D. Advanced Orthopaedics Sports Medicine Center PH: (804) 270-1305 FX: (804) 273-9294 www.advancedortho.me Reverse Total Shoulder Protocol General Information: Reverse Total ShoulderMore information
Bankart Repair using the Smith & Nephew BIORAPTOR 2.9 Suture Anchor
Shoulder Series Technique Guide *smith&nephew BIORAPTOR 2.9 Suture Anchor Bankart Repair using the Smith & Nephew BIORAPTOR 2.9 Suture Anchor Gary M. Gartsman, M.D. Introduction Arthroscopic studies ofMore information
REHAB 544 FUNCTIONAL ANATOMY OF THE UPPER EXTREMITY & LOWER EXTREMITY Mark Guthrie, PhD Rehabilitation Medicine University of Washington REHAB 544: Musculoskeletal Anatomy of the Upper & Lower Extremities,More information
Rotator Cuff Impingement/Tendinopathy
Rotator Cuff Impingement/Tendinopathy Anatomy and Biomechanics The shoulder is a wonderfully complex joint that is made up of the ball and socket connection between the humerus (ball) and the glenoid portionMore information
Kinematical Analysis of the Elbow Joint during Push-up
Kinematical Analysis of the Elbow Joint during Push-up Hamzah Sakeran, Mohd Shahril bin Salim School of Mechatronic Engineering, Universiti Malaysia Perlis (UniMAP). Abstract- Muscle strength of upperMore information
Rotator Cuff Pathophysiology. treatment program that will effectively treat it. The tricky part about the shoulder is that it is a ball and
Rotator Cuff Pathophysiology Shoulder injuries occur to most people at least once in their life. This highly mobile and versatile joint is one of the most common reasons people visit their health careMore information
The Pilates Studio of Los Angeles / PilatesCertificationOnline.com
Anatomy Review Part I Anatomical Terminology and Review Questions (through pg. 80) Define the following: 1. Sagittal Plane 2. Frontal or Coronal Plane 3. Horizontal Plane 4. Superior 5. Inferior 6. AnteriorMore information
Shoulder Examination
Shoulder Examination Consultant Orthopaedic Surgeon West Herts NHS Trust Spire Harpenden & Spire Bushey Hospitals LOOK Swellings SCJ, ACJ Scars shoulder but also neck! Muscle wasting deltoid, supraspinatusMore information
Questions. Close-packed: Maximum congruency, tight i.e. Knee extension
Plane: Sagittal Axis: Coronal Action: Flexion/Extension Plane: Frontal AKA Coronal Axis: Sagittal Abduction/Adduction Plane: Transverse AKA Horizontal Axis: Vertical Rotation Cardinal Plane: where allMore information
Darren C. McAuley, D.O. MMEL AOBNM, CAQ SM, CAQ PM Assistant Professor Department of Osteopathic Manipulative Medicine Philadelphia College of Osteopathic Medicine The upper extremity of the throwing athleteMore information
Lumbar/Core Strength and Stability Exercises
Athletic Medicine Lumbar/Core Strength and Stability Exercises Introduction Low back pain can be the result of many different things. Pain can be triggered by some combination of overuse, muscle strain,More information
Shoulder Injuries. Why Bother? QAS Injury Prevalence. Screening Injury 29.2% 12 month cumulative injury prevalence. Dr Simon Locke
Shoulder Injuries Dr Simon Locke Why Bother? Are shoulder and upper limb injuries common? Some anatomy What, where, what sports? How do they happen? Treatment, advances? QAS Injury Prevalence ScreeningMore information
Shoulder Arthroscopic Capsular Release Rehabilitation
Shoulder Arthroscopic Capsular Release Rehabilitation Phase one: 0 to 4 weeks after surgery Goals: 1. Improve range of motion of the shoulder and prevent adhesions from forming 2. Begin gentle strengtheningMore information
Occupational Therapy Manual for Evaluation of Range of Motion and Muscle Strength
Licensed to: CengageBrain User Licensed to: CengageBrain User Occupational Therapy Manual for Evaluation of Range of Motion and Muscle Strength DONNA LATELLA, MA, OTR/L Assistant Professor Department ofMore information
Impingement Syndrome of the Shoulder & Rotator Cuff Problems
H U N T E R D O N ORTHOPEDIC P.A. INSTITUTE L IVE L IFE B ETTER www.hunterdonortho.com Impingement Syndrome of the Shoulder & Rotator Cuff Problems Types of Injuries Treatment Options Rehabilitation RobertMore information
SLAP Repair Protocol
SLAP Repair Protocol Anatomy and Biomechanics The shoulder is a wonderfully complex joint that is made up of the ball and socket connection between the humerus (ball) and the glenoid portion of the scapulaMore information
QUESTION I HAVE BEEN ASKED TO REHAB GRADE II AND III MCL INJURIES DIFFERENTLY BY DIFFERENT SURGEONS IN THE FIRST 6WEEKS FOLLOWING INJURY. SOME ARE HINGE BRACED 0-90 DEGREES AND ASKED TO REHAB INCLUDINGMore information
Gregory N. Lervick, MD Jason Ash, ATC, PA-C POSTSURGICAL CORACOACROMIAL DECOMPRESSION REHABILITATION PROTOCOL
Phase 1: Weeks 0-4 Gregory N. Lervick, MD Jason Ash, ATC, PA-C POSTSURGICAL CORACOACROMIAL DECOMPRESSION REHABILITATION PROTOCOL Acromioplasty Coracoplasty Distal clavicle resection Biceps tenodesis RotatorMore information
Strength Training for the Shoulder
Strength Training for the Shoulder This handout is a guide to help you safely build strength and establish an effective weighttraining program for the shoulder. Starting Your Weight Training Program StartMore information
Diagnosis of Acromioclavicular Joint Injuries
PO Box 15 Rocky Hill, CT 06067 (860) 463-9003 email@example.com www.chirocredit.com ChiroCredit.com is proud to present a section from one of our continuing education programs: Physical DiagnosisMore information
Muscle Energy Technique. Applied to the Shoulder
Muscle Energy Technique Applied to the Shoulder MUSCLE ENERGY Theory Muscle energy technique is a manual therapy procedure which involves the voluntary contraction of a muscle in a precisely controlledMore information
Shoulder. Clinical Assessment of the. The approach to a physical examination of the
Focus on CME at the University of British Columbia Clinical Assessment of the Shoulder When assessing shoulder pain, a structured physical examination, as directed by the patient s history, allows theMore information
KIN Biomechanics
KIN 335 - Biomechanics LAB: Center of Mass (Center of Gravity) of the Human Body Reading Assignment: Bishop, R.D. & Hay, J.G. (1979). Basketball: the mechanics of hanging in the air. Medicine and ScienceMore information
Biomechanics of Overarm Throwing. Deborah L. King, PhD
Biomechanics of Overarm Throwing Deborah L. King, PhD Ithaca College, Department of Exercise and Sport Science Outline Review Fundamental Concepts Breakdown Throwing Motion o Identify Key Movements o ExamineMore information
MANAGEMENT OF SCAPULAR DYSKINESIA supplement to Comprehensive Approach to the Management of Scapular Dyskinesia in the Overhead Throwing Athlete UPMC Rehab Grand Rounds Fall 2012 1A. Scapular Clock atMore information
UHealth Sports Medicine
UHealth Sports Medicine Rehabilitation Guidelines for Arthroscopic Rotator Cuff Repair Type 2 Repairs with Bicep Tenodesis (+/- subacromial decompression) The rehabilitation guidelines are presented inMore information
Pilates for the treatment of Rounded Shoulders
Pilates for the treatment of Rounded Shoulders Nicola Heweston September 2015 Wimbledon UK, January 2014 Abstract Rounded shoulders is a description of a common posture abnormality whereby the shouldersMore information
Shoulder Orthopedic Tests
Shoulder Orthopedic Tests Tendinitis (Supraspinatus) Supraspinatus tendinitis is a common inflammatory condition of the shoulder that causes anterior shoulder pain. Pain is present especially in abduction.More information
Technique Guide. 3.5 mm LCP Clavicle Hook Plates. Part of the Synthes locking compression plate (LCP) system.
Technique Guide 3.5 mm LCP Clavicle Hook Plates. Part of the Synthes locking compression plate (LCP) system. Table of Contents Introduction 3.5 mm LCP Clavicle Hook Plates 2 AO Principles 4 IndicationsMore information
Rehabilitation Exercises for Shoulder Injuries Pendulum Exercise: Wal Walk: Back Scratcher:
Rehabilitation Exercises for Shoulder Injuries Begin these exercises when your pain has decreased about 25% from the time when your injury was most painful. Pendulum Exercise: Lean over with your uninjuredMore information
LOURDES MEDICAL ASSOCIATES PROFESSIONAL ORTHOPAEDICS SPORTS MEDICINE & ARTHROSCOPY Sean Mc Millan, DO Director of Orthopaedic Sports Medicine & Arthroscopy 2103 Burlington-Mount Holly Rd Burlington, NJMore information
Range of Motion. A guide for you after spinal cord injury. Spinal Cord Injury Rehabilitation Program
Range of Motion A guide for you after spinal cord injury Spinal Cord Injury Rehabilitation Program This booklet has been written by the health care providers who provide care to people who have a spinalMore information
Hand and Upper Extremity Injuries in Outdoor Activities. John A. Schneider, M.D.
Hand and Upper Extremity Injuries in Outdoor Activities John A. Schneider, M.D. Biographical Sketch Dr. Schneider is an orthopedic surgeon that specializes in the treatment of hand and upper extremityMore information
Prevention & Management of ACL Injury. Ian Horsley PhD, MCSP Lee Herrington PhD, MCSP
Prevention & Management of ACL Injury Ian Horsley PhD, MCSP Lee Herrington PhD, MCSP ACL injury ACL injury 30/100,000, 40% sports injuries (NHS) Limited statistics in UK related to sport Rugby Union 2002-2004More information
Rehabilitation after ACL Reconstruction: From the OR to the Playing Field. Mark V. Paterno PT, PhD, MBA, SCS, ATC
Objectives Rehabilitation after ACL Reconstruction: From the OR to the Playing Field Mark V. Paterno PT, PhD, MBA, SCS, ATC Coordinator of Orthopaedic and Sports Physical Therapy Cincinnati Children sMore information
UHealth Sports Medicine
UHealth Sports Medicine Rehabilitation Guidelines for Arthroscopic Rotator Cuff Repair with Bicep Tenodesis Type 1 Repairs (+/- subacromial decompression) The rehabilitation guidelines are presented inMore information
Shoulder Injury Prevention and Rehabilitation for Health & Fitness Professionals
s EDUCATION WORKSHOPS Shoulder Injury Prevention and Rehabilitation for Health & Fitness Professionals with B.App.Sc (Physio), Dip.Ed (P.E.) CONTENTS Topic Page 1. Functional Anatomy 3 2. ScapulohumeralMore information
Arthroscopic Repair of Superior Labral Anterior-Posterior (SLAP) Injuries- Dr. Trueblood
Arthroscopic Repair of Superior Labral Anterior-Posterior (SLAP) Injuries- Dr. Trueblood Indications: Pain and disability of the shoulder secondary to the detachment of the long head of the biceps originMore information
Review Monday s Lecture. Why learn body mechanics? Principles of body mechanics How to prepare Traditional Lift Model Golfer s Lift
Review Monday s Lecture Why learn body mechanics? Principles of body mechanics How to prepare Traditional Lift Model Golfer s Lift The goal of transfer training is Some skills learned for one transferMore information
The Buchberger-12 rotatorcuff and scapular stabilizing program
The Buchberger-12 rotatorcuff and scapular stabilizing program Dale J. Büchberger, DC Past-President, American Chiropractic Board of Sports Physicians Team Chiropractor, Auburn Doubleday s and SyracuseMore information
Injury Prevention Strategies and Mechanics for Softball Players. Jason Yoder, DPT. Clinic Coordinator Sports Rehab Center for Sports Medicine
Injury Prevention Strategies and Mechanics for Softball Players Jason Yoder, DPT Clinic Coordinator Sports Rehab Center for Sports Medicine Objectives Identify similarities and differences among the sportsMore information
SLAP Lesion Repair Rehabilitation Protocol Dr. Mark Adickes
SLAP Lesion Repair Rehabilitation Protocol Dr. Mark Adickes Introduction: This rehabilitation protocol has been developed for the patient following a SLAP (Superior Labrum Anterior Posterior) repair. ItMore information
Jane Gillham B.AppSc. (Physiotherapy) Cowra Physiotherapy & Health Supplies Bronze Licensed Swim Coach - ASCTA
Jane Gillham B.AppSc. (Physiotherapy) Bronze Licensed Swim Coach - ASCTA Acknowledgements Peter Blanch The Swimming Machine Andrea Mosler AIS physio and shoulder guru Brett Doring physio for Carlile SwimmingMore information
Learning Objective Radiology Anatomy of the Spine and Upper Extremity Identify anatomic structures of the spine and upper extremities on standard radiographic and cross-sectional images Timothy J. Mosher,More information
Osteokinematics (how the bones move) & Arthrokinematics (how the joints move)
Osteokinematics (how the bones move) & Arthrokinematics (how the joints move) Planes & Axes Planes of Action = Three fixed lines of reference along which the body is divided. Each plane is at right anglesMore information
Arthroscopic Shoulder Procedures. David C. Neuschwander MD. Shoulder Instability. Allegheny Health Network Orthopedic Associates of Pittsburgh
Arthroscopic Shoulder Procedures David C. Neuschwander MD Allegheny Health Network Orthopedic Associates of Pittsburgh Shoulder Instability Anterior Instability Posterior Instability Glenohumeral JointMore information
Arthroscopic Labral Repair Protocol-Type II, IV, and Complex Tears:
Department of Rehabilitation Services Physical Therapy This protocol has been adopted from Brotzman & Wilk, which has been published in Brotzman SB, Wilk KE, Clinical Orthopeadic Rehabilitation. Philadelphia,More information


text:
We've stayed at numerous hotels that are near airports; I'd have to say that this was the best of the lot. Ours was a huge, clean, well appointed room near the lobby, but not so close that we had any hint of noise.
And when I asked if it might be possible for their shuttle to pick me up when I returned our rental car to the airport area, the answer was not one I really expected! The answer was "of course we will". And they did so promptly after I called when I finished returning the vehicle.
My only "negatives" are that there is only one restaurant nearby, and while OK, it wasn't exceptional dining. Also, their architect or contractor really missed the mark on the closet. The closet's depth was so inadequate that one could not close the bi-fold door without turning the hangers to a 45 degree angle. But because almost all people stay just a night or two, that should not constitute a real impediment. All in all, we were more than pleased.
- Official Description (provided by the hotel):
- The BEST WESTERN Airport Albuquerque InnSuites Hotel & Suites is located just a few blocks from the Albuquerque International Airport -- ABQ. Hotel guests looking for a great location will find themselves near Kirtland Air Force Base, Sandia National Labs and the University of New Mexico. Popular events near the hotel include the Albuquerque International Balloon Fiesta and Gathering of Nations Pow-Wow. Other popular attractions near the hotel include The Rio Grande Zoological Park, Albuquerque Aquarium, and Rio Grande Botanic Garden in Albuquerque. The Sandia Peak Ariel Tramway & Ski is just a short drive away. ... more less
- Reservation Options:
- TripAdvisor is proud to partner with Booking.com, Expedia, Orbitz, Best Western, Travelocity, Priceline, Hotels.com, TripOnline SA, Cheap Tickets, Hotwire, getaroom.com, Cancelon and HotelQuickly so you can book your Best Western Airport Albuquerque InnSuites Hotel & Suites reservations with confidence. We help millions of travelers each month to find the perfect hotel for both vacation and business trips, always with the best discounts and special offers.
- Also Known As:
- Best Western Albuquerque
- Albuquerque Best Western


text:
The first rolling of the Baton Rouge Halloween Parade is set for 2 p.m. Oct. 29 in downtown Baton Rouge.
The parade is being put on by the 10/31 Consortium, a local nonprofit benefiting Our Lady of the Lake Children's Hospital, the Greater Baton Rouge Food Bank and the Baton Rouge Big Buddy Program. Sponsors include Gerry Lane Enterprises and the 13th Gate Haunted House.
The theme is "First Fright: Something Wicked This Way Comes!"
The parade will have a variety of costumed characters and floats with an assortment of Halloween decorations.
These include themes such as Alice in Wonderland, Where the Wild Things Are, Cleopatra's Revenge Belly Dancers and zombies.
The 13th Gate also will have a horse-drawn hearse in the parade. Other special groups include the Baton Rouge Big Buddy Program, the Marching Band Project and the Baton Rouge Caledonian Pipes and Drums.
The grand marshal of the inaugural parade is the mummy from the Louisiana Arts and Science Museum.
"The LASM Mummy is a perfect representation of Halloween in Baton Rouge," said Kelley Criscoe, the parade's founder.
Spectators are asked to donate nonperishable food to the Food Bank along the parade route.
The route will include a no-alcohol zone on Convention Street between Fifth and Sixth streets.
For a complete route map or more information on the parade and its parent organization, go to http://www.1031Consortium.com or follow "Baton Rouge Halloween Parade" on Facebook.


text:
? Place an order in the next
Hours Minutes . Overweight charges may apply to some items.
Not the correct shipping zip code? Update your information below.
Enter a valid zip code
Please select options for this product
Estimated Delivery for
Change Shipping Destination
(based on 1 review)
Reviewed by 1 customer
Displaying review 1
Back to top
get a size larger
By bikerjoe
from chicago il
About Me Casual/ Recreational
Best Uses
Comments about Canari Arm Warmers:
useful in cool weather or to block the sun from arms
Bottom Line Yes, I would recommend this to a friend
Was this review helpful? Yes / No
- You may also flag this review
Item No. »
We Make Shopping Safe, Secure and Easy
© 2017 Nashbar. All Rights Reserved.
Return to Mobile


text:
DOP Chennai 15th Nov Ans Key 2015 Post Man & Mail Guard Cut Off Result Date
Department Of Post, Tamil Nadu Postal Circle have released a notification for the posts of Post Man and Mail Guard recently. The candidates have submitted their applications and now the organization is going to conduct the examination which is scheduled on 15th November 2015. The candidates who are participating for the recruitment, after completing their examination, will start searching for the Answer Keys for DOP Chennai Post man recruitment-2015, Answer Keys for DOP Chennai Mail Guard recruitment-2015, Expected Cutoff marks for DOP Chennai Post man recruitment-2015, Expected Cutoff marks for DOP Chennai Mail Guard recruitment-2015, Results for DOP Chennai Post man recruitment-2015 and Results for DOP Chennai Mail Guard recruitment-2015.
Key Information On Chennai Post Exam Result 2015
The Tamil Nadu Postal Circle is the organization which is going to conduct the examination through which it is going to recruit the Post Man and Mail Guard posts. The exam date is on 15th Nov-2015 and as expected, many candidates are taking their active participation for the exam. After 15th November, the only thing candidates need is answer key, cutoff marks to estimate their results and finally the officially released results to confirm their estimation.
Recruitment Details Of DOP Tamil Nadu:
- Organization: Department Of Posts, Tamil Nadu Postal Circle.
- Official Page: www.dopchennai.in.
- Post Name: Post Man and Mail Guard.
- Exam Date: 15th Nov-2015.
- Category: Answer Keys, Expected Cutoff Marks and Results for DOP Recruitment-2015.
- Status: Will be available after the completion of examination.
How To Download The Answer Key, Cutoff Marks And Results For TN Postal Circle Exam-2015?
- Log on to http://dopchennai.in/
- Click on the Answer Key download for the exam you have appeared for.
- Select the Key which was allotted to you during the examination.
- Tally the answers and estimate your results.
- Now Go through cutoff link and check whether there is a chance to get shortlisted or not.
- Now wait for the organization to release the results officially whose information will be updated here too.
Click me to get the DOP Chennai 2015 Key result information.


text:
Say Yes to the Dress
Like Mother, Unlike Daughter
Season 13 Episode 14
Valerie's budget is unlimited thanks to Dad, but Mom disagrees with her sexy dress choices. Bride Napiera wants a ball gown, but both her mother and former "TV mom" think form fitting is best. Haley lets her mother do the dress shopping for her!
- 22 min
- Premiered 05/08/2015


text:
Contemporary Masterpiece
Ideal location. Nearly a straight shot up San Ysidro Road from the upper village of Montecito, this spectacular gated ocean view Paul Gray home sits majestically on the hillside with unhindered views of the Channel Islands. The property is extremely secluded yet incredibly easy to access, and only a short distance to the San Ysidro Ranch. Pull into the vast gravel motor-court and enjoy the unique and dramatic California setting. The home features a large approx. 15 foot ceiling living room with large glass doors opening to ocean views and expansive ocean view patios. There is a grand formal entry hall, a sleek modern kitchen, and a beautiful formal dining room that opens to an outdoor ocean view patio. There are 5 bedrooms, 4 full baths, and 2 half baths. Two of the 5 bedrooms and full bath are in a separate guest suite, attached to the home. The ocean view master is on the main level, and the large recreation/screening room and two en suite bedrooms are located in the lower level. All lower level rooms open to outdoor patios. The property also features a large rear garden/yard with room for a pool, there is a koi pond in a tranquil side garden, and an interior elevator connecting the main and lower levels.


text:
0 items ·
Check out
is back-ordered. We will ship it separately in 10 to 15 days.
Locker wallpaper fits most standard size school lockers (12" x 18" x 36").
Hangs in seconds with super-strong magnets (included).
Pre-cut into 4 easy-to-install panels.
Copyright © 2017 Capital Books and Wellness. Ecommerce Software by Shopify.


text: Hi everyone. If any of you guys/girls have a spare passenger headlight for an A3/S3 S-Line 5 doors, please pm me I would buy it off you. it has to be with Xenon Housing etc. Car is 56 plate. 3.2 Quattro I can pick up if its within 50 miles of London and pay cash on collection.


text: Charles Foster Welles (3 March, 1955 - 7 May, 1963) was the second son of United States President Orson Welles and Janet McHenry. Charles was named after his father's first film Citizen Kane 's main character, Charles Foster Kane. He drowned and died in 1963 at the age of eight while on a sailing trip celebrating his father's 48th birthday. He was given a state burial in Washington, D.C. broadcast by the national television networks.


text: Errata is text retroactively applied to a card by Wizards that changes the function of the card in some way. Retrieved from "http://mtg.wikia.com/wiki/Errata?oldid=59250" Ad blocker interference detected! Wikia is a free-to-use site that makes money from advertising. We have a modified experience for viewers using ad blockers Wikia is not accessible if you've made further modifications. Remove the custom ad blocker rule(s) and the page will load as expected. Categories: Terms


text:
What's the next tandem at the scoring altar?
Updated: October 14, 2004, 4:17 PM ETBy Terry Brown | NBA Insider
The amazing thing about the pairing of Kobe Bryant and Shaquille O'Neal is not that they were able to average a combined 52.96 points per game together, but that they were able to do it for the last five years.
In the beginning of their championship run, it was Shaq averaging 29.7 points per game. Near the end of their dynasty, it was Kobe averaging 30 points per game. In between, each became the best player at his respective position, if not the best players in the NBA.
Year in and year out, they were the more prolific scoring 1-2 punch in the NBA -- until they almost came to blows themselves. But this is a new year, and there is no more pairing of Shaq and Kobe, or Kobe and Shaq, leaving an open void for the next dynamic duo to step up.
To continue reading this article you must be an Insider
Become an insider and get access to all our articles and toolsView Insider Benefits »
Magazine subscribers: activate your Insider account.
- Haberstroh: NBA's best duo?
- Ford/Pelton: Is Russell a future Lakers star?
- Pelton: Curry a unanimous MVP?
- 5-on-5: Celtics boast best second-half upside
- Ford: Ben Simmons or Brandon Ingram?


text:
From the trunk of a car he terrified a Nation.
A mysterious shooter randomly kills innocent citizens in public; one after the other in broad daylight. All murders happen not far from the White House; not far from the President.
This is D.C. Sniper and you are watching MovieZion
Please wait for 3 seconds, we are loading D.C. Sniper stream.
Please enter captcha to continue to video.
If the above stream is offline (saying We are sorry!),
please click on the "Refresh Link" to get a new streaming link. Don't worry it'll just take a second.


text: Sorting type: Most visited Most visited Alphabetical | Characters killed by Tiberius Pages in category "Characters killed by Tiberius" Crixus Sabinus Canthara Totus Retrieved from "http://spartacus.wikia.com/wiki/Category:Characters_killed_by_Tiberius?oldid=47361" Ad blocker interference detected! Wikia is a free-to-use site that makes money from advertising. We have a modified experience for viewers using ad blockers Wikia is not accessible if you've made further modifications. Remove the custom ad blocker rule(s) and the page will load as expected. Categories: Characters by killer Characters Deceased Add category Cancel Save