Ensuring glenohumeral stability during repetitive lifting tasks is a key factor to reduce the risk of shoulder injuries. Nevertheless, the literature reveals some lack concerning the assessment of the muscles that ensure glenohumeral stability during specific lifting tasks. Therefore, the purpose of this study was to assess the stabilization function of shoulder muscles during a lifting task. Kinematics and muscle electromyograms (n = 9) were recorded from 13 healthy adults during a bi-manual lifting task performed from the hip to the shoulder level. A generic upper-limb OpenSim model was implemented to simulate glenohumeral stability and instability by performing static optimizations with and without glenohumeral stability constraints. This procedure enabled to compute the level of shoulder muscle activity and forces in the two conditions. Without the stability constraint, the simulated movement was unstable during 74%±16% of the time. The force of the supraspinatus was significantly increased of 107% (p<0.002) when the glenohumeral stability constraint was implemented. The increased supraspinatus force led to greater compressive force (p<0.001) and smaller shear force (p<0.001), which contributed to improved glenohumeral stability. It was concluded that the supraspinatus may be the main contributor to glenohumeral stability during lifting task.

Goal: Little information is available in the existing literature regarding the influence of the scapular kinematic estimate method on musculoskeletal analysis. This study aimed to assess the propagation of errors due to the method used for scapular kinematics reconstruction in the workflow of musculoskeletal modeling (joint kinematics, joint torques, muscle force and joint reaction force) in shoulder and upper-limb movements. Two participants performed functional (arm elevation and rotation), daily life (eating and reaching pants pockets) and sports movements (a simulated throwing maneuver). Shoulder kinematics were obtained with five multibody kinematics methods: intra-cortical pins (Pins, reference method), International Society of Biomechanics (ISB), Jackson (Jack), Projection (Proj) and Ellipsoid (Ell) methods. For the five kinematics methods, joint torques, muscle forces and glenohumeral joint reaction forces were computed with the Delft Shoulder and Elbow musculoskeletal model. Differences up to 30° in glenohumeral joint kinematics, compared to the Pins method, resulted in differences less than 3 N.m in joint torque estimation. However, these also resulted in differences up to 50 N and 831 N in the muscle force and joint reaction force estimate, respectively, in comparison to the reference method (Pins). No method yielded the worst or best results in comparison to the Pins method but the differences were task-specific. We concluded that shoulder biomechanical studies based on skin markers should be completed with caution when assessing joint angles, muscle forces and glenohumeral joint reaction forces, while researchers may be more confident with the evaluation of shoulder joint torques.

The primary role of the shoulder joint in tennis forehand drive is at the expense of the loadings undergone by this joint. Nevertheless, few studies investigated glenohumeral (GH) contact forces during forehand drives. The aim of this study was to investigate GH compressive and shearing forces during the flat and topspin forehand drives in advanced tennis players. 3D kinematics of flat and topspin forehand drives of 11 advanced tennis players were recorded. The Delft Shoulder and Elbow musculoskeletal model was implemented to assess the magnitude and orientation of GH contact forces during the forehand drives. The results showed no differences in magnitude and orientation of GH contact forces between the flat and topspin forehand drives. The estimated maximal GH contact force during the forward swing phase was 3573 ± 1383 N, which was on average 1.25 times greater than during the follow-through phase, and 5.8 times greater than during the backswing phase. Regardless the phase of the forehand drive, GH contact forces pointed towards the anterior-superior part of the glenoid therefore standing for shearing forces. Knowledge of GH contact forces during real sport tasks performed at high velocity may improve the understanding of various sport-specific adaptations and causative factors for shoulder problems.

Objective: While the sensitivity of estimated muscle forces to muscle-tendon properties is well documented for the lower limbs, little is known about the shoulder and upper limbs. The purpose of this study was to assess the sensitivity of estimated shoulder muscle forces and scapulohumeral joint force to muscle-tendon properties. Methods: One healthy male participant performed arm flexions and simulated throwing maneuvers. Kinematics were recorded using intra-cortical pins. Muscle forces were estimated using static optimization with the generic Delft Shoulder and Elbow in OpenSim, and scapulohumeral joint forces were calculated from the estimated forces. Then, variations from - 25% to +25% of the nominal values of the tendon slack length, the optimal fiber length, the maximal isometric force and the pennation angle were applied to the musculoskeletal model to compute affected muscle forces and scapulohumeral joint force. Results: The variations in muscle-tendon properties led to changes up to 9.6 N or 174% in the muscle nominal forces. The more sensitive muscles were those that produced the greatest force: the rotator cuff muscles and the prime movers specific to the task. Among the four muscle-tendon properties, the maximal isometric force and the optimal fiber length had the greatest influence on the muscle force variability. Glenohumeral force was slightly influenced by muscle-tendon properties ( $< 8%$ ). Conclusion: Generic models (i.e., those without personalization of muscle-tendon properties) can lead to misinterpretations of muscle force. Efforts should focus on the maximal isometric force and the optimal fiber length of the rotator cuff muscles and prime movers.