Shoulder Impingement Symptoms Research Articles

THE PREVALENCE AND PROFILE OF AFRICAN PATIENTS WITH OS ACROMIALE THAT PRESENT WITH SHOULDER PAIN AT A TERTIARY HOSPITAL IN PRETORIA, SOUTH AFRICA

Os acromiale is a developmental defect caused by failure of fusion of the anterior epiphysis of the acromion between the ages of 22 and 25. The prevalence of os acromiale in the general population ranges from 1.4% to 15%. Os acromiale has been reported as a contributory factor to shoulder impingement symptoms and rotator cuff injuries, despite being a common incidental observation. In this retrospective study, we examined the prevalence of os acromiale in black African patients with shoulder pain.We retrospectively reviewed the clinical records, radiographs, and magnetic resonance imaging (MRI) scans of 119 patients who presented with atraumatic and minor traumatic shoulder pain at a single institution over a one-year period. Anteroposterior, scapula Y-view, and axillary view plain images were initially evaluated for the presence of os acromiale, and this was corroborated with axial MRI image findings. Patients with verified os acromiale had their medical records reviewed to determine their first complaint and the results of their clinical examination and imaging examination.Radiographs and MRI on 24 patients (20%) revealed an osacromiale. This cohort had a mean age of 59.2 years, and there were significantly more females (65%) than males. Meso-acromion was identified as the most prevalent type (n=11), followed by pre-os acromion (n=7). All patients underwent bilateral shoulder x-rays, and 45 percent of patients were found to have bilateral meso- acromion. Most patients (70%) were reported to have unstable os acromiale with subacromial impingement symptoms, and nine patients (36%) had confirmed rotator cuff tears based on clinical and Mri findings. Surgery was necessary for 47% of the 24 patients with confirmed Os acromiale (arthroscopic surgery, n=7; open surgery, n=1) in order to treat their symptomsThe prevalence of os acromiale in our African patients with atraumatic shoulder symptoms is greater than that reported in the general population. Os acromiale is a rare condition that should always be considered when evaluating shoulder pain patients.

Effect of Motor Control Based Shoulder Retraining Exercises on Supraspinatus Impingement

Background: Supraspinatus muscle impingement is a condition in which the muscle gets impinged in the articulating surfaces of the shoulder. The musculoskeletal dysfunction affects the region under acromion, its bursa, the tendon part of the supraspinatus gets affected by this musculoskeletal dysfunction. Methods Young male Individuals consisting of 40 numbers complaining of shoulder impingement symptoms were selected under the inclusion and exclusion criteria under which the individuals were allotted into two (Control Group A and Experimental Group B), each consisting of 20. They then underwent initial pre-intervention test with SPADI questionnaire and ROM assessment. The individuals then were given the assigned intervention. Results and Interpretation The analysis predicted that shoulder retaining exercises based on motor control is significant. Conclusion Motor control retraining exercise was proved highly effective than conventional exercises in alleviation of pain and increasing shoulder ROM and functional capability of supraspinatus impingement.

Comparison of specific and non-specific treatment approaches for individuals with posterior capsule tightness and shoulder impingement symptoms: A randomized controlled trial

BackgroundPosterior capsule tightness (PCT) is associated with shoulder pain and altered shoulder kinematics, range of motion (ROM), external rotation (ER) strength, and pain sensitization. ObjectiveTo assess the effects of two interventions on shoulder kinematics, Shoulder Pain and Disability Index (SPADI) scores, ROM, strength, and pressure pain threshold (PPT) in individuals with PCT and shoulder impingement symptoms. MethodsIn this prospectively registered randomized controlled trial 59 individuals were randomized to either an Experimental Intervention Group (EIG, n=31) or a Control Intervention Group (CIG, n=28). The low flexion (LF) test was used to determine the presence of PCT. Shoulder kinematics, SPADI scores, internal rotation (IR) and ER ROM, ER strength, and PPT were measured pre- and post-treatment. Those in the EIG received an intervention specific to pain and PCT and those in the CIG received a non-specific intervention, both 4 weeks in duration. ResultsIndividuals in the EIG demonstrated more scapular upward rotation (P=.03; mean difference (MD)=3.3°; 95% Confidence Interval (CI)=1.3°, 4.9°) and improved value on the LF test (P=.02; MD=4.6°; 95%CI=0.7°, 8.6°) than those in the CIG after treatment. Both groups presented less anterior (P<.01; MD=-0.7mm; 95%CI=-1.3mm, -0.2mm) and superior (P<.01; MD=-0.5mm; 95%CI=-0.9mm, -0.2mm) humeral translations, decreased SPADI score (P<.01; MD=-23.6; 95%CI=-28.7, -18.4), increased IR ROM (P<.01; MD=4.6°; 95%CI=1.8°, 7.8°) and PPTs for upper trapezius (P<.01; MD=60.1kPa; 95%CI=29.3kPa, 90.9kPa), infraspinatus (P=.04; MD=47.3kPa; 95%CI=2.1kPa, 92.5kPa), supraspinatus (P<.01; MD=63.7kPa; 95%CI=29.6kPa, 97.9kPa), and deltoid (P<.01; MD=40.9kPa; 95%CI=12.3kPa, 69.4kPa) after treatment. ConclusionThe experimental intervention was more effective at improving PCT as measured through changes in the LF test. No benefit of the specific approach over the non-specific intervention was noted for the remaining variables.

Taping with Active Exercises Versus Active Exercise Alone in Management of Shoulder Impingement Syndrome Subjects

Background of study: Shoulder problems are common complaint of the musculoskeletal system. Of all the shoulder problems shoulder impingement syndrome is one of the common. Treatment of shoulder impingement symptoms commonly includes exercises at first instance. Taping has been seen as an alternative treatment in SIS. Methods: A total of thirty patients were diagnosed with shoulder impingement syndrome. Among which 27 (F=11(40.7%) M=16(59.3%)) stayed were assigned to one of two treatment groups. 15 subjects in group A were treated with exercises along with some conventional pain modality (US or IFT). Subjects in group B (12) were treated with exercises along with taping. Taping was done once a week. Results: Within group comparison was done using paired t-test and between groups comparison was done using independent t- test with p – values matched at less than 0.001. There was significant improvement in SDQ and VAS in both groups. In group A SDQ improved from 59.53 ± 13.87 to 18.87 ± 15.32 and VAS decreased from 6.27 ± 1.44 to 2.00 ± 1.56. And in group B SDQ improved from 62.70 ± 19.47 to 23.05 ± 19.33 and VAS score decreased from 6.75 ± 1.71 to 1.92 ± 1.62. There was some improvement in ROM scores of shoulder flexion abduction and scaption in both groups but that was not significant. Conclusion: In conclusion there is promising evidence for efficacy of exercise treatment along with taping and other pain modalities in treatment of shoulder impingement syndrome. And it should be the choice of treatment in pry health care. However when comparing exercise along taping with exercises along with other pain modality. There is no such difference that one treatment option is better than second.

Initial experience with 18F-sodium fluoride (NaF) PET-CT: a viable functional biomarker in symptomatic Os acromiale.

Os acromiale (OA) is a failure of complete fusion of the acromial process. It is usually asymptomatic and discovered incidentally. OA can contribute to shoulder impingement symptoms and rotator cuff tears. 18F Sodium Fluoride (NaF) Positron Emission Tomography-CT (PET-CT) is an emerging and highly sensitive modality for oncological skeletal staging, and can show a variety of non-malignant uptake. We have analysed the relationship between 18F-NaF uptake in OA and associated symptoms of shoulder pain. Study population included 21 patients (mean age 60.2 ± 12years; 13 females and 8 males) with OA who underwent PET-CT scan by injecting 2.22MBqkg-1 of 18F-NaF. The relationship between 18F-NaF uptake and OA as a cause of pain was analysed. A 3-point grading system was used to evaluate uptake of 18F-NaF. In total 27 OA (12 symptomatic and 15 asymptomatic) were enrolled. All symptomatic OA showed focal increase tracer uptake of Grade 2, while asymptomatic OA did not have significant activity Grade 0 (n = 11) and Grade 1 (n = 4). 18F-NaF PET-CT appears to be a useful adjunct in the assessment of symptomatic OA with its particular strength being its high negative predictive value. Advances in knowledge: 18F-NaF PET-CT may be used as an ancillary tool for identifying symptomatic OA as a cause of shoulder pain in cases where other obvious causes of shoulder pain have been excluded.

Scapular-focused exercise treatment protocol for shoulder impingement symptoms: Three-dimensional scapular kinematics analysis

BackgroundThe present study aimed to describe the effects of a periscapular strengthening and neuromuscular training protocol in three-dimensional scapular kinematics and resting positioning in participants with shoulder impingement symptoms. Self-reported function was also evaluated. MethodThe study group comprised 50 subjects with shoulder impingement syndrome (control group, n=25; treatment group, n=25). The treatment group underwent 8weeks of neuromuscular training and periscapular strengthening. Scapular kinematics was measured using an electromagnetic tracking device, and the Brazilian version of the Shoulder Pain and Disability Index (SPADI-Br) questionnaire was carried out before and after the treatment. FindingsIn the resting position, treated subjects had lower (p<0.01) internal rotation of the scapula compared to the control group, with a large effect size (2.4). On the coronal plane, the treated group had less scapular upward rotation (p<0.01) and less internal rotation (p<0.05), with a medium effect size. On the sagittal plane, the treated group had less internal rotation (p<0.01), less upward rotation (p<0.05), and less scapular anterior tilt (p<0.01), with a medium effect size. On the scapular plane, a reduction in upward rotation (p<0.01) after the intervention was observed, with a large effect size. Moreover, a reduction in the total SPADI-Br score was found, with a mean difference of 32.4 [24.4; 40.4] points (p<0.01) after the implementation of the protocol and a large effect size (2.0). InterpretationThe results provide biomechanical support for the clinical rationale for indicating therapeutic exercises focused on the periscapular muscles to improve scapular dynamics.

Thoracic Spine Manipulation in Individuals With Subacromial Impingement Syndrome Does Not Immediately Alter Thoracic Spine Kinematics, Thoracic Excursion, or Scapular Kinematics: A Randomized Controlled Trial.

Randomized controlled trial. To determine if thoracic spinal manipulative therapy (SMT) alters thoracic kinematics, thoracic excursion, and scapular kinematics compared to a sham SMT in individuals with subacromial impingement syndrome, and also to compare changes in patient-reported outcomes between treatment groups. Prior studies indicate that thoracic SMT can improve pain and disability in individuals with subacromial impingment syndrome. However, the mechanisms underlying these benefits are not well understood. Participants with shoulder impingement symptoms (n = 52) were randomly assigned to receive a single session of thoracic SMT or sham SMT. Thoracic and scapular kinematics during active arm elevation and overall thoracic excursion were measured before and after the intervention. Patient-reported outcomes measured were pain (numeric pain-rating scale), function (Penn Shoulder Score), and global rating of change. Following the intervention, there were no significant differences in changes between groups for thoracic kinematics or excursion, scapular kinematics, and patient-reported outcomes (P>.05). Both groups showed an increase in scapular internal rotation during arm raising (mean, 0.9°; 95% confidence interval [CI]: 0.3°, 1.6°; P = .003) and lowering (0.8°; 95% CI: 0.0°, 1.5°; P = .041), as well as improved pain reported on the numeric pain-rating scale (1.2 points; 95% CI: 0.3, 1.8; P<.001) and function on the Penn Shoulder Score (9.1 points; 95% CI: 6.5, 11.7; P<.001). Thoracic spine extension and excursion did not change significantly following thoracic SMT. There were small but likely not clinically meaningful changes in scapular internal rotation in both groups. Patient-reported pain and function improved in both groups; however, there were no significant differences in the changes between the SMT and the sham SMT groups. Overall, patient-reported outcomes improved in both groups without meaningful changes to thoracic or scapular motion. Therapy, level 1b-.

Scapular kinematics pre- and post-thoracic thrust manipulation in individuals with and without shoulder impingement symptoms: a randomized controlled study.

Randomized controlled trial with immediate follow-up. To evaluate the immediate effects of a low-amplitude, high-velocity thrust thoracic spine manipulation (TSM) on pain and scapular kinematics during elevation and lowering of the arm in individuals with shoulder impingement syndrome (SIS). The secondary objective was to evaluate the immediate effects of TSM on scapular kinematics during elevation and lowering of the arm in individuals without symptoms. Considering the regional interdependence among the shoulder and the thoracic and cervical spines, TSM may improve pain and function in individuals with SIS. Comparing individuals with SIS to those without shoulder pathology may provide information on the effects of TSM specifically in those with SIS. Fifty subjects (mean ± SD age, 31.8 ± 10.9 years) with SIS and 47 subjects (age, 25.8 ± 5.0 years) asymptomatic for shoulder dysfunction were randomly assigned to 1 of 2 interventions: TSM or a sham intervention. Scapular kinematics were analyzed during elevation and lowering of the arm in the sagittal plane, and a numeric pain rating scale was used to assess shoulder pain during arm movement at preintervention and postintervention. For those in the SIS group, shoulder pain was reduced immediately after TSM and the sham intervention (mean ± SD preintervention, 2.9 ± 2.5; postintervention, 2.3 ± 2.5; P<.01; moderate effect size [Cohen d = 0.2]). Scapular internal rotation increased 0.5° ± 0.02° (P = .04; small effect size [Cohen d<0.1]) during elevation of the arm after TSM and sham intervention in the SIS group only. Subjects with and without SIS who received TSM and asymptomatic subjects who received the sham intervention had a significant increase (1.6° ± 2.7°) in scapular upward rotation postintervention (P<.05; small effect size [Cohen d<0.2]), which was not considered clinically significant. Scapular anterior tilt increased 1.0° ± 4.8° during elevation and lowering of the arm postmanipulation (P<.05; small effect size [Cohen d<0.2]) in the asymptomatic subjects who received TSM. Shoulder pain in individuals with SIS immediately decreased after a TSM. The observed changes in scapular kinematics following TSM were not considered clinically important. Therapy, level 4. J Orthop Sports Phys Ther 2014;44(7):475-487. Epub 22 May 2014. doi:10.2519/jospt.2014.4760.

Interrater and intrarater reliability of the pectoralis minor muscle length measurement in subjects with and without shoulder impingement symptoms

Measuring the pectoralis minor muscle length (PML) is of clinical interest, as a short PML has been associated with a decrease of scapular posterior tilting and shoulder pain. However, as no reliability data are available at present, the objective of this study was to examine the inter- and intrarater reliability of the PML measurement in both subjects with and without shoulder impingement symptoms (SIS). Therefore, two assessors performed the PML measurement (3 times/shoulder) in 25 patients with SIS and 25 pain-free controls. Both assessors were blinded for each other's findings. For reliability testing, intra-class coefficients (ICCs; model 2,1) and standard errors of measurements were calculated. Intrarater reliability analysis resulted with ICCs ranging from 0.87 (Standard error of measurement (SEM) 0.21–0.27%) (symptomatic) to 0.93 (SEM 0.19–0.30%) (asymptomatic) in patients with SIS, representing excellent test-retest agreement. Healthy subjects presented with ICCs ranging from 0.76 (SEM 0.29–0.32%) (dominant side) to 0.87 (SEM 0.21–0.32%) (non-dominant side), representing good test-retest agreement. ICCs and SEMs on the symptomatic and asymptomatic side (0.48 and 0.46%; 0.56 and 0.61%) in SIS patients, and on the two sides (non-dominant; 0.47 and 0.45%, dominant; 0.53 and 0.38% respectively) in healthy subjects showed moderate interrater reliability and low dispersion of the measurement errors. We concluded that the PML measurement has good to excellent intrarater reliability and poor to moderate interrater reliability.

Zusammenhang zwischen Schulter-Impingement-Syndrom und Defiziten in der Schlägerkopfgeschwindigkeit bei leistungsstarken Amateurgolfspielern

Joint structure damages due to overstrain often occur even in commonly not injury-prone golfing. Triggered by the golf swing's repetitive movement pattern and technique deficits of the player these structural damages are most likely to affect the lumbar spine as well as shoulder and elbow joint. As a synonym for shoulder impingement symptoms in golfers the term golf shoulder has been established in medical terminology. Despite this fact, currently there exist no studies addressing the relation between shoulder impingement syndrome and club head velocity. The aim of this study was to highlight the relation between club head velocity deficits of high-performance amateur golfers and persisting shoulder impingement syndrome. All of the 31 high-performance amateur golfers included in this study were male, active tournament players and right hander. Each golfer was examined for shoulder impingement syndrome using the Neer test, the Hawkins-Kennedy test, the painful arc and the functional test of the M. infraspinatus. Based on the test results the participants were allocated to an impingement group or a non-impingement group. Additionally, each golfer's club head velocity was determined. Between the two groups a significant difference concerning the club head velocity has been reported. A persisting shoulder impingement syndrome can have a negative effect on club head velocity. In many shoulder studies predominantly the influence of pathological muscular balance alterations (myofascial dysfunction) is not taken into consideration.

Clinical implications of scapular dyskinesis in shoulder injury: the 2013 consensus statement from the ‘scapular summit’

The second international consensus conference on the scapula was held in Lexington Kentucky. The purpose of the conference was to update, present and discuss the accumulated knowledge regarding scapular involvement...

Does Scapula Taping Facilitate Recovery for Shoulder Impingement Symptoms? A Pilot Randomized Controlled Trial

Scapula taping is a commonly used adjunctive treatment for shoulder im- pingement pathology. However, this intervention has not previously been subject to formal investigation. A pilot single-blind randomized controlled trial was conducted to evaluate facilitatory taping as an adjunct to routine physiotherapy management. Twenty-two sub- jects with unilateral shoulder impingement symptoms were randomized into a taping with routine physiotherapy or a routine physiotherapy only group. The intervention group had scapula taping applied three times per week for the first two weeks of their treatment. All subjects were assessed at baseline, then at 2 and 6 weeks after the commencement of treat- ment. Pain and functional ability were assessed using the Shoulder Pain and Disability In- dex, range of shoulder elevation, and self-reported pain on elevation. At 2 weeks, the taping group demonstrated a strong trend toward reduced pain both on self-reported activity (SPADI pain subscale mean for taping 27.0 versus 41.5 for control) and pain during mea- sured abduction (mean VAS 22.8 for taped, 46.8 for control), statistical power being limited by small sample size. No similar trend was evident in the SPADI disability subscale. The magnitude of the differences was reduced at 6-week follow-up. This study provides prelimi- nary evidence for a short-term role for scapula taping as an adjunct to routine physiother- apy in the management of shoulder impingement symptoms but also highlights the need for consideration on a case basis relating to risk factors for skin reaction.

Effect of the Scapula Reposition Test on Shoulder Impingement Symptoms and Elevation Strength in Overhead Athletes

Effect of the Scapula Reposition Test on Shoulder Impingement Symptoms and Elevation Strength in Overhead Athletes

Effect of the Scapula Reposition Test on Shoulder Impingement Symptoms and Elevation Strength in Overhead Athletes

Two group, repeated measures design. To determine whether manually repositioning the scapula using the Scapula Reposition Test (SRT) reduces pain and increases shoulder elevation strength in athletes with and without positive signs of shoulder impingement. Symptom alteration tests may be useful in determining a subset of those with shoulder pathology who may benefit from interventions aimed at improving scapular motion abnormalities. One hundred forty-two college athletes underwent testing for clinical signs of shoulder impingement. Tests provoking symptoms were repeated with the scapula manually repositioned into greater retraction and posterior tilt. A numeric rating scale was used to measure symptom intensity under both conditions. Isometric shoulder elevation strength was measured using a mounted dynamometer with the scapula in its natural position and with manual repositioning. A paired t test was used to compare the strength between positions. The frequency of a significant increase in strength with scapular repositioning, defined as the minimal detectable change (90% confidence interval), was also assessed. Of the 98 athletes with a positive impingement test, 46 had reduced pain with scapular repositioning. Although repositioning produced an increase in strength in both the impingement (P=.001) and non-impingement groups (P=.012), a significant increase in strength was found with repositioning in only 26% of athletes with, and 29% of athletes without positive signs for shoulder impingement. The SRT is a simple clinical test that may potentially be useful in an impairment based classification approach to shoulder problems.

Clinical Trial of Exercise for Shoulder Pain in Chronic Spinal Injury

The high prevalence of shoulder pain in wheelchair users may be related to the repetitive use of the upper limbs during self-care and wheelchair-related activities. The purpose of this study was to determine the effects of a controlled 8-week, scapula-focused exercise intervention on pain and functional disability in people with spinal cord injury (SCI) and shoulder impingement symptoms. Forty-one manual wheelchair users (with SCI and spina bifida), both with (n=21) and without (n=20) shoulder impingement symptoms, participated. The study design was a clinical trial with an asymptomatic control group. Subjects completed the Wheelchair User's Shoulder Pain Index (WUSPI) and the Shoulder Rating Questionnaire (SRQ) and provided patient satisfaction scores at initial and 8-week visits. Subjects in the intervention group were instructed in a home exercise program consisting of stretching and strengthening exercises. Subjects in the asymptomatic control group received no intervention. An analysis of variance model was used to test for group and time effects for the WUSPI, SRQ, and satisfaction scores. Subjects in the intervention group showed significant improvements in all measures as a result of the intervention, whereas asymptomatic control group subjects remained stable. A selective 8-week home exercise program is effective in reducing pain and improving function and satisfaction in this population of wheelchair users.

Symptomatic Os Acromiale

Os acromiale, the joining of the acromion to the scapular spine by fibrocartilaginous tissue rather than bone, is an anatomic variant that has been reported in approximately 8% of the population worldwide. It is more common in blacks and males than in whites and females. Although it is often an incidental finding, os acromiale has been identified as a contributor to shoulder impingement symptoms and rotator cuff tears. When nonsurgical management of a symptomatic os acromiale fails to relieve symptoms, surgical intervention is considered. Options include os acromiale excision, open reduction and internal fixation, and arthroscopic decompression. Excision usually is reserved for small to midsized fragments (preacromion) or after failed open reduction and internal fixation. Persistent deltoid dysfunction may result from excision of a large os acromiale. Open reduction and internal fixation preserves large fragments while maintaining deltoid function. Cannulated screw fixation has been shown to result in good union rates. Arthroscopic techniques have shown mixed results when used for treating impingement secondary to an unstable os acromiale. Associated rotator cuff tears may be addressed arthroscopically or through an open transacromial approach, followed by open reduction and internal fixation of the os acromiale.

Suprascapular nerve injuries

The suprascapular nerve provides enervation to the supraspinatus and infraspinatus rotator cuff muscles. Injury to the nerve may subsequently result in significant rotator cuff dysfunction. Because the rotator cuff is a dynamic stabilizer to the shoulder joint, impingement symptoms and instability patterns may be encountered, as well as direct nerve and secondary rotator cuff pain. This review focuses on the major patterns of suprascapular nerve injury and their associated anatomic, clinical, and diagnostic findings. Lastly, treatment options are considered with support provided by recent clinical research.

Evaluation of the symptomatic supraspinatus tendon—a comparison of ultrasound and arthroscopy

Purpose: A prospective study was undertaken to determine the accuracy of ultrasound compared with arthroscopy in the evaluation of the symptomatic supraspinatus tendon, and to identify whether ultrasound diagnosis was helpful in pre-operative planning.Methods: A total of 276 consecutive patients with shoulder impingement symptoms underwent ultrasound examination of the supraspinatus tendon. Of these patients, 41 proceeded to open or arthroscopic surgical procedure on clinical grounds, and in this group direct comparison with ultrasound findings was made.Results: There was full correlation between ultrasound and arthroscopy in the diagnosis of a normal supraspinatus tendon, full-thickness tear, tendinopathy and tendon rupture. There was some discrepancy between the two techniques. Two patients with partial thickness tear on ultrasound had a full thickness tear at arthroscopy. Ultrasound was able to identify intra-substance partial thickness tears in three patients with supraspinatus tendon said to be normal at arthroscopy. Ultrasound helped plan the surgical approach and operative time needed in cases of supraspinatus tendon rupture and full thickness tear.Conclusion: In this study ultrasound was effective in the evaluation of the symptomatic supraspinatus tendon, and was also able to diagnose intra-tendinous lesions not visible at arthroscopy.

Translations of the humerus in persons with shoulder impingement symptoms.

Two-group mixed-model analysis of covariance and correlation analysis. To determine whether differences in humeral translations exist between patients with shoulder impingement symptoms and an asymptomatic comparison group, and if so, to determine if shoulder range-of-motion (ROM) measures are associated with abnormal translations. Abnormal translations of the humeral head are believed to reduce the available subacromial space and to contribute to the development or progression of shoulder impingement symptoms. These abnormal translations have also been theorized to be related to tightness of the posterior capsule and decreased shoulder ROM. Three-dimensional humeral translations were tracked in symptomatic construction workers and an asymptomatic comparison group while elevating the arm in the scapular plane under no-load, 2.3-kg, and 4.6-kg hand-load conditions. Between-group comparisons were made across 3 phases of motion (30 degrees-60 degrees, 60 degrees-90 degrees, and 90 degrees-120 degrees) and the association between humeral translations and cross-body adduction and shoulder internal rotation ROM measures were determined by Pearson correlation analysis. Persons with shoulder symptoms demonstrated small but significant changes in anterior-posterior translations of the humerus. These changes for the 90 degrees-120 degrees phase of humeral elevation were moderately negatively associated with available cross-body adduction ROM. The identified kinematic deviations are consistent with possible reductions of the subacromial space. Further study of relationships between posterior capsule tightness, rotator cuff function, and abnormal humeral translations is warranted to better delineate underlying kinematic mechanisms that may contribute to shoulder impingement symptoms and to refine rehabilitation techniques.

Histopathological Examination of the Inferior Acromial Surface in Patients with Shoulder Impingement Symptoms

Histopathological Examination of the Inferior Acromial Surface in Patients with Shoulder Impingement Symptoms