The Relationship between Stress and Health-related Quality of Life is Mediated by Shoulder Pain, Shoulder Disorder, and Depression

The purpose of this study is to analyze the mediating effect of shoulder pain, shoulder disorder, and depression in the relationship between stress and health-related quality of life in middle-aged women using a serial mediation model. For this study, data was collected from middle-aged women aged between 35 and 64 living in Seoul, South Korea, from May 13, 2021 to May 23, 2021. Data regarding stress, health-related quality of life, shoulder pain, shoulder disorder, and depression were collected using a self-reported, structured survey. SPSS macro process (Model 6) was used, and the relationship between stress and health-related quality of life of participants were analyzed using serial mediation analysis using shoulder pain, shoulder disorder, and depression as variables. From the results of the study, it was observed that stress has a statistically direct impact on health-related quality of life. On performing serial mediation analysis, shoulder pain, shoulder disorder, and depression were found to be statistically significant, which predicts the relationship between stress and health-related quality of life; the variables showed an explanatory power of 33% for influencing the quality of life. Therefore, the relationship between stress and health-related quality of life was found to be partially mediated by shoulder pain, shoulder disorder, and depression. This study suggests the need for healthcare workers to develop a method, such as exercise intervention programs based on various degrees and types of physical activity, for improving the health-related quality of life and reducing stress caused by shoulder pain, shoulder disorder, and depression in middle-aged women.

MicroRNA-29a Mitigates Subacromial Bursa Fibrosis in Rotator Cuff Lesion with Shoulder Stiffness

Rotator cuff lesion with shoulder stiffness is a major cause of shoulder pain and motionlessness. Subacromial bursa fibrosis is a prominent pathological feature of the shoulder disorder. MicroRNA-29a (miR-29a) regulates fibrosis in various tissues; however, the miR-29a action to subacromial bursa fibrosis remains elusive. Here, we reveal that subacromial synovium in patients with rotator cuff tear with shoulder stiffness showed severe fibrosis, hypertrophy, and hyperangiogenesis histopathology along with significant increases in fibrotic matrices collagen (COL) 1A1, 3A1, and 4A1 and inflammatory cytokines, whereas miR-29a expression was downregulated. Supraspinatus and infraspinatus tenotomy-injured shoulders in transgenic mice overexpressing miR-29a showed mild swelling, vascularization, fibrosis, and regular gait profiles as compared to severe rotator cuff damage in wild-type mice. Treatment with miR-29a precursor compromised COL3A1 production and hypervascularization in injured shoulders. In vitro, gain of miR-29a function attenuated COL3A1 expression through binding to the 3’-untranslated region (3′-UTR) of COL3A1 in inflamed tenocytes, whereas silencing miR-29a increased the matrix expression. Taken together, miR-29a loss is correlated with subacromial bursa inflammation and fibrosis in rotator cuff tear with shoulder stiffness. miR-29a repressed subacromial bursa fibrosis through directly targeting COL3A1 mRNA, improving rotator cuff integrity and shoulder function. Collective analysis offers a new insight into the molecular mechanism underlying rotator cuff tear with shoulder stiffness. This study also highlights the remedial potential of miR-29a precursor for alleviating the shoulder disorder.

Infraspinatus and Teres Minor Tendon Calcification with Severe Pain

Calcific tendinitis is an extremely common shoulder disorder which affects 2.7 to 10.3% of the adult population. However, clear details regarding the formation of calcific tendinitis have only been found recently, and its pathology still under debate. In this report, we present a case of calcific tendinitis affect both the infraspinatus and the teres minor tendon with both X-ray and ultrasound findings. Calcific tendinitis at the infraspinatus is rare (around 8.4% in all rotator cuff calcific tendinitis), and no separate case report on calcific tendinitis has been reported in the teres minor region in the preceding several years, therefore, the rarity of reporting this case was considered.4 We assume that additional case reports can help to further improve our understanding regarding infraspinatus and teres minor tendon calcification.

Scapular Kinematics During Late Cocking of a Simulated Throwing Activity in Baseball Players With Shoulder Injury: A Cross-Sectional Study Using a 3D-to-2D Registration Technique

Context:Abnormal scapular kinematics during throwing motion in baseball players with shoulder disorders has not yet been clarified, although altered scapular position has been suggested to be associated with shoulder disorder.Objective:To determine if the shoulders of baseball players with throwing disorders demonstrate abnormal scapular kinematics during the simulated arm-cocking phase of throwing activity.Design:Cross sectional study.Setting:Laboratory.Participants:Eleven baseball players (age 21.1 ± 1.2 y) with a unilateral shoulder disorder volunteered to participate, including 9 players at the college level and 2 at the adult level. The mean playing experience was 12.1 ± 2.7 y.Main Outcome Measures:Scapular upward/downward rotation, anteroposterior tilting, and external/internal rotation during simulated arm-cocking motion were analyzed using a 3-to-2-dimensional registration technique.Results:Scapular external rotation in the throwing shoulder was significantly smaller by 2.0–6.0° than that of the contralateral shoulder. There were no detectable differences in scapular upward/downward rotation or anteroposterior tilting between the throwing and contralateral shoulders.Conclusions:Compared with that in the contralateral shoulder, scapular external rotation was smaller in the throwing shoulder, which would increase glenohumeral horizontal abduction during the arm-cocking phase and be related to the throwing-shoulder disorder.