Conservative Management of Shoulder Impingement Syndrome in the Athletic Population

1999 ◽  
Vol 8 (3) ◽  
pp. 230-253 ◽  
Author(s):  
Joseph B. Myers
Keyword(s):  
Rehabilitation Program ◽  
Impingement Syndrome ◽  
Subacromial Bursa ◽  
Glenohumeral Instability ◽  
Shoulder Impingement ◽  
Overhead Athletes ◽  
Athletic Population ◽  
Common Complaint ◽  
Complex Anatomy ◽  
Cause Of Pain

Shoulder pain is a common complaint among overhead athletes. Oftentimes, the cause of pain is impingement of the supraspinatus, bicipital tendon, and subacromial bursa between the greater tuberosity and the acromial arch. The mechanisms of impingement syndrome include anatomical abnormalities, muscle weakness and fatigue of the glenohumeral and scapular stabilizers, posterior capsular tightness, and glenohumeral instability. In order to effectively manage impingement syndrome nonoperatively, the therapist must understand the complex anatomy and biomechanics of the shoulder joint, as well as how to thoroughly evaluate the athlete. The results of the evaluation can then be used to design and implement a rehabilitation program that addresses the cause of impingement specific to the athlete. The purpose of this article is to provide readers with a thorough overview of what causes impingement and how to effectively evaluate and conservatively manage it in an athletic population.

Psychometric Properties of the Hindi Version of SPADI in Overhead Athletes With Shoulder Impingement Syndrome

2018 ◽  
Vol 23 (6) ◽  
pp. 246-252
Author(s):  
Saurabh Sharma ◽  
M. Ejaz Hussain
Keyword(s):  
Psychometric Properties ◽  
Internal Consistency ◽  
Convergent Validity ◽  
Impingement Syndrome ◽  
Minimal Detectable Change ◽  
Shoulder Impingement Syndrome ◽  
Factor Solution ◽  
Shoulder Impingement ◽  
Overhead Athletes ◽  
Test Retest Reliability

Patient-related outcome measures are often used for assessing and determining management efficacy of shoulder impingement syndrome (SIS) in overhead athletes. This study was undertaken to examine the psychometric properties (structural validity, convergent validity, internal consistency, test-retest reliability, and minimal detectable change) and perform partial confirmatory factor analysis (PCFA) of the Hindi SPADI. Eighty male athletes with a mean age of 21.5 ± 2.20 years were enrolled in the study. Hindi SPADI test-retest reproducibility was calculated by intraclass correlation coefficient (ICC2,1), and Cronbach alpha helped determine internal consistency of the index. Pearson correlation coefficient compared the Hindi SPADI with the Hindi DASH scale to determine convergent validity, while the measurement error was calculated by minimal detectable change (MDC95). Exploratory factor analysis utilized for assessing the structural validity of the index gave a five-factor solution, which explained 70.03% of the variances. The test-retest reliability (ICC2,1), internal consistency, and convergent validity were found to be high, at 0.87, 0.75, and 0.94, respectively. The MDC95was calculated to be 14.20. Additionally, the PCFA confirmed the five-factor solution with fit indices. This Hindi version of SPADI demonstrated satisfactory psychometric properties in overhead athletes with shoulder impingement syndrome.

scholarly journals Progressive Resistance Exercises plus Manual Therapy Is Effective in Improving Isometric Strength in Overhead Athletes with Shoulder Impingement Syndrome: A Randomized Controlled Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Saurabh Sharma ◽  
Amer K. Ghrouz ◽  
M. Ejaz Hussain ◽  
Shalini Sharma ◽  
Mosab Aldabbas ◽  
...  
Keyword(s):  
Motor Control ◽  
Manual Therapy ◽  
Impingement Syndrome ◽  
Isometric Strength ◽  
Shoulder Impingement Syndrome ◽  
Pronounced Increase ◽  
Shoulder Impingement ◽  
Overhead Athletes ◽  
Resistance Exercises ◽  
Progressive Resistance

Reduction in isometric strength of the scapulohumeral muscles is a commonly seen impairment in overhead athletes afflicted with shoulder impingement syndrome (SIS). The purpose of this study was to compare the effects of two different treatment programs: progressive resistance exercises plus manual therapy (PRE plus MT) and motor control exercises (MCE), on isometric strength of upper trapezius (UT), middle trapezius (MTr), lower trapezius (LT), serratus anterior (SA), supraspinatus (Supr.), anterior deltoid (A.D), and latissimus dorsi (LD). 80 male university-level overhead athletes clinically diagnosed with SIS were randomly allocated into either of the two groups: PRE plus MT and MCE group. Athletes in the PRE plus MT group underwent graduated exercises with resistance elastic band, stretching exercises, and mobilization of the thoracic and shoulder joints. MCE group was submitted to motor control exercises in varied planar positions. Athletes in both groups underwent management 3 times a week for 8 weeks. Isometric strength of UT, MTr, LT, Supr, A.D, SA, and LD was measured at three-time points: baseline, 4th week, and 8th week. Relative to baseline, both interventions were found to be effective in increasing and optimizing the isometric strength of muscles ( p < 0.05 ) except for supraspinatus in the MCE group ( p > 0.05 ). However, athletes in PRE plus MT group presented a more pronounced increase in isometric strength than those in the MCE group. Between groups analysis found the largest isometric strength improvement in PRE plus MT group for A.D, followed by Supr. and UT muscles ( p < 0.05 ; effect size: 0.39 to 0.40). The study concluded that compared to MCE, PRE plus MT provides greater improvement in the isometric strength of scapulohumeral muscles.

scholarly journals Shoulder Function and 3-Dimensional Kinematics in People With Shoulder Impingement Syndrome Before and After a 6-Week Exercise Program

2004 ◽  
Vol 84 (9) ◽  
pp. 832-848 ◽  
Author(s):  
Philip W McClure ◽  
Jason Bialker ◽  
Nancy Neff ◽  
Gerald Williams ◽  
Andrew Karduna
Keyword(s):  
Functional Limitations ◽  
Exercise Program ◽  
Shoulder Function ◽  
Rehabilitation Program ◽  
Impingement Syndrome ◽  
Shoulder Impingement Syndrome ◽  
Shoulder Impingement ◽  
3 Dimensional ◽  
Scapular Kinematics ◽  
And Function

Abstract Background and Purpose. Shoulder impingement syndrome is a common condition and is often managed with an exercise program. The purpose of this study was to examine an exercise program in patients with shoulder impingement syndrome. Specifically, the purpose was to identify changes that might occur in 3-dimensional scapular kinematics, physical impairments, and functional limitations. Subjects. Fifty-nine patients with impingement syndrome were recruited, and 39 patients successfully completed the 6-week rehabilitation program and follow-up testing. Impingement was defined as having at least 3 of 6 predefined clinical signs or symptoms. Methods. Subjects were assessed before and after a 6-week rehabilitation program and again at 6 months. Pain, satisfaction, and function were measured using the University of Pennsylvania Shoulder Scale. Range of motion, isometric muscle force, and 3-dimensional scapular kinematic data also were collected. Subjects were given a progressive exercise program that included resistive strengthening, stretching, and postural exercises that were done daily at home. Subjects also were given shoulder education related to anatomy, the basic mechanics of impingement, and strategies for reducing load on the shoulder. Each subject attended one physical therapy session per week for a 6-week period, primarily for monitoring and upgrading the exercise program. Pretest and posttest scores were compared using paired t tests and repeated-measures analysis of variance. Results. Passive range of motion increased for both external and internal rotation but not for elevation. Abduction external and internal rotation force all increased. There were no differences in scapular kinematics. Improvements were found for pain, satisfaction, and shoulder function and for Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) scores related to physical function. At 6-month follow-up, improvements made in pain, satisfaction, and function were maintained. Discussion and Conclusion. The use of this exercise protocol in the management of shoulder impingement syndrome may have a positive impact on patients' impairments and functional limitations. Our findings suggest a relatively simple exercise program combined with patient education may be effective and, therefore, merits study in a larger trial using a control group. Changes in scapular kinematics did not appear to be a primary mechanism underlying improvement in symptoms and function.

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