Abstract
Purpose: To evaluate the correlation between subscapularis insufficiency and functional subacromial impingement syndrome (SAIS). Patients and Methods: Twenty patients with nonstructural subacromial impingement with at least one positive clinical test including Neer’s, Hawkins Kennedy, and Codman drop arm test, were recruited for this observational study. Subscapularis weakness was evaluated clinically via Gerber lift-off test, Bear Hug test and by Belly Press test, and by dynamometer, and its insufficiency was confirmed by evaluating changes in muscle atrophy and fatty infiltration on magnetic resonance imaging (MRI). Subscapularis weakness was then matched with radiological parameters of proximal migration of shoulder, namely upward migration index (UMI) and Acromiohumeral interval (AHI) on X-ray and MRI, respectively. Results: A significant association (P < 0.05) was seen between subscapularis insufficiency and radiological parameters of SAIS, namely UMI and AHI. Conclusion: There exists a significant positive correlation between subscapularis insufficiency and proximal migration of humerus. Patients with clinical and radiological signs of subacromial impingement and without any evidence of structural abnormality should be investigated for an underlying subscapularis insufficiency.
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