Nonoperative Treatment of a Patient With Shoulder Pain and a History of Sternoclavicular Fracture-Dislocation

in International Journal of Athletic Therapy and Training
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A 59-year-old male was referred to physical therapy due to shoulder pain. Computed axial tomography reveled a previous sternoclavicular injury, consistent with fracture-dislocation. This report describes the rehabilitation process of the patient with shoulder pain and a history of sternoclavicular joint fracture-dislocation. Thoracic mobility exercises, glenohumeral mobilizations, muscle strengthening, neuromuscular reeducation, and pain science education were used. The patient exhibited improvement in regard to pain, mobility, muscle strength, and self-reported questionnaires.

The authors are with the Physical Therapy Unit, Santojanni Hospital, Buenos Aires, Argentina.

Villalba (federicojosevillalba@gmail.com) is corresponding author.
  • 1.

    Luime JJ, Koes BW, Hendriksen IJ, et al. Prevalence and incidence of shoulder pain in the general population; a systematic review. Scand J Rheumatol. 2004; 33(2):7381. PubMed ID: 15163107 doi:10.1080/03009740310004667

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Boesmueller S, Wech M, Tiefenboeck TM, et al. Incidence, characteristics, and long-term follow-up of sternoclavicular injuries: an epidemiologic analysis of 92 cases. J Trauma Acute Care Surg. 2016;80(2):289295. PubMed ID: 26491798 doi:10.1097/TA.0000000000000888

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Rockwood, Matsen, Wirth, Lippit. Hombro. Editorial Marbán. 3° edición. España, Spain; 2006: 597649.

  • 4.

    Morell DJ, Thyagarajan DS. Sternoclavicular joint dislocation and its management: a review of the literature. World J Orthop. 2016;7(4):244250. PubMed ID: 27114931 doi:10.5312/wjo.v7.i4.244

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Wettstein M, Borens O, Garofalo R, Kombot C, Chevalley F, Mouhsine E. Anterior subluxation after reduction of a posterior traumatic sterno-clavicular dislocation: a case report and a review of the literature. Knee Surg Sports Traumatol Arthrosc. 2004;12(5):453456. PubMed ID: 15175849 doi:10.1007/s00167-004-0504-x

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Kirby JC, Edwards E, Kamali Moaveni A. Management and functional outcomes following sternoclavicular joint dislocation. Injury. 2015;46(10):19061913. PubMed ID: 26169233 doi:10.1016/j.injury.2015.05.050

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Bontempo NA, Mazzocca AD. Biomechanics and treatment of acromioclavicular and sternoclavicular joint injuries. Br J Sports Med. 2010;44(5):361369. PubMed ID: 20371562 doi:10.1136/bjsm.2009.059295

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Riley DS, Barber MS, Kienle GS, et al. CARE guidelines for case reports: explanation and elaboration document. J Clin Epidemiol. 2017;89:218235. PubMed ID: 28529185 doi:10.1016/j.jclinepi.2017.04.026

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001;94(2):149158. PubMed ID: 11690728 doi:10.1016/S0304-3959(01)00349-9

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;(214):160164.

  • 11.

    Manske R, Wilk KE, Davies G, Ellenbecker T, Reinold M. Glenohumeral motion deficits: friend or foe? Int J Sports Phys Ther. 2013;8(5):537553. PubMed ID: 24175137

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Laudner KG, Stanek JM, Meister K. Assessing posterior shoulder contracture: the reliability and validity of measuring glenohumeral joint horizontal adduction. J Athl Train. 2006;41(4):375380. PubMed ID: 17273461

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Werner BC, Holzgrefe RE, Griffin JW, et al. Validation of an innovative method of shoulder range-of-motion measurement using a smartphone clinometer application. J Shoulder Elbow Surg. 2014;23(11):e275e282. PubMed ID: 24925699 doi:10.1016/j.jse.2014.02.030

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Johnson KD, Kim KM, Yu BK, Saliba SA, Grindstaff TL. Reliability of thoracic spine rotation range-of-motion measurements in healthy adults. J Athl Train. 2012;47(1):5260. PubMed ID: 22488230 doi:10.4085/1062-6050-47.1.52

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Kibler WB, Sciascia A, Dome D. Evaluation of apparent and absolute supraspinatus strength in patients with shoulder injury using the scapular retraction test. Am J Sports Med. 2006;34(10):16431647. PubMed ID: 16735587 doi:10.1177/0363546506288728

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Rabin A, Irrgang JJ, Fitzgerald GK, Eubanks A. The intertester reliability of the Scapular Assistance Test. J Orthop Sports Phys Ther. 2006;36(9):653660. PubMed ID: 17017270 doi:10.2519/jospt.2006.2234

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Dib P, Andreu M, Cardoso G, García Schustereder S, Galloli M. Confiabilidad y mínimo cambio detectable de la medición de fuerza de rotadores de hombro con handgrip en individuos sanos. En: XI CongresoArgentino de KinesiologíadelDeporte; 2018 Aug 30, 31 and Sep 1. City of Buenos Aires, Argentina.

    • Search Google Scholar
    • Export Citation
  • 18.

    Policastro PO, Pierobon A, Pérez J, Novoa GA, Calvo Delfino M, et al. Cross-cultural adaptation and validation of the Argentine “American Shoulder and elbow surgeons, patient self-report section” questionnaire. Musculoskelet Sci Pract. 2019;43:3744. PubMed ID: 31220777 doi:10.1016/j.msksp.2019.05.010

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Gómez-Pérez L, López-Martínez AE, Ruiz-Párraga GT. Psychometric properties of the Spanish version of the Tampa Scale for Kinesiophobia (TSK). J Pain. 2011;12(4):425435. doi:10.1016/j.jpain.2010.08.004

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Sullivan MJL, Bishop SR, Pivik J. The pain catastrophizing scale: development and validation. Psychol Assess. 1995;7:524532. doi:10.1037/1040-3590.7.4.524

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    EuroQol Group. EuroQol--a new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199208. doi:10.1016/0168-8510(90)90421-9

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Klintberg IH, Cools AM, Holmgren TM, et al. Consensus for physiotherapy for shoulder pain. Int Orthop. 2015;39(4):715720. PubMed ID: 25548127 doi:10.1007/s00264-014-2639-9

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Mitchell C, Adebajo A, Hay E, Carr A. Shoulder pain: diagnosis and management in primary care [review]. BMJ. 2005;331(7525):11241128. PubMed ID: 16282408 doi:10.1136/bmj.331.7525.1124

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Terra BB, Rodrigues LM, Pádua DV, Martins MG, Teixeira JC, De Nadai A. Sternoclavicular dislocation: case report and surgicaltechnique. Rev Bras Ortop. 2015;50(4):472477. PubMed ID: 26401506 doi:10.1016/j.rbo.2014.07.013

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Reuther KE, Larsen R, Kuhn PD, Kelly JD, Thomas SJ. Sleeper stretch accelerates recovery of glenohumeral internal rotation after pitching. J Shoulder Elbow Surg. 2016;25(12):19251929. PubMed ID: 27745803 doi:10.1016/j.jse.2016.07.075

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Louw A, Diener I, Butler DS, Puentedura EJ. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain. Arch Phys Med Rehabil. 2011;92(12):20412056. PubMed ID: 22133255 doi:10.1016/j.apmr.2011.07.198

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Louw A, Puentedura EJ, Zimney K, Schmidt S. Know Pain, Know Gain? A Perspective on Pain Neuroscience Education in Physical Therapy. J Orthop Sports Phys Ther. 2016;46(3):131134. PubMed ID: 26928735 doi:10.2519/jospt.2016.0602

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Lehman G. Recovery Strategies. Your Pain Guidebook. Author: Canada; 2017.

  • 29.

    Louw A, Zimney K, O’Hotto C, Hilton S. The clinical application of teaching people about pain. Physiother Theory Pract. 2016;32(5):385395. PubMed ID: 27351903 doi:10.1080/09593985.2016.1194652

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Hartman SE. Why do ineffective treatments seem helpful? A brief review. Chiropr Osteopat. 2009;17:10. PubMed ID: 19822008 doi:10.1186/1746-1340-17-10

  • 31.

    Laudner KG, Sipes RC, Wilson JT. The acute effects of sleeper stretches on shoulder range of motion. J Athl Train. 2008;43(4):359363. PubMed ID: 18668168 doi:10.4085/1062-6050-43.4.359

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Manske RC, Meschke M, Porter A, Smith B, Reiman M. A randomized controlled single-blinded comparison of stretching versus stretching and joint mobilization for posterior shoulder tightness measured by internal rotation motion loss. Sports Health. 2010;2(2):94100. PubMed ID: 23015927 doi:10.1177/1941738109347775

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Theodoridis D, Ruston S. The effect of shoulder movements on thoracic spine 3D motion. Clin Biomech. 2002;17(5):418421. doi:10.1016/S0268-0033(02)00026-8

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34.

    Barrett E, O’Keeffe M, O’sullivan K, Lewis J, McCreesh K. Is thoracic spine posture associated with shoulder pain, range of motion and function? A systematic review. Man Ther. 2016;26:3846. PubMed ID: 27475532 doi:10.1016/j.math.2016.07.008

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Barrett E, Conroy C, Corcoran M, et al. An evaluation of two types of exercise classes, containing shoulder exercises or a combination of shoulder and thoracic exercises, for the treatment of nonspecific shoulder pain: a case series. J Hand Ther. 2018;31(3):301307. PubMed ID: 29217293 doi:10.1016/j.jht.2017.10.011

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36.

    Kibler WB, Sciascia AD, Uhl TL, Tambay N, Cunningham T. Electromyographic analysis of specific exercises for scapular control in early phases of shoulder rehabilitation. Am J Sports Med. 2008;36(9):1789. PubMed ID: 18469224 doi:10.1177/0363546508316281

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Schory A, Bidinger E, Wolf J, Murray L. A systematic review of the exercises that produce optimal muscle ratios of the scapular stabilizers in normal shoulders. Int J Sports Phys Ther. 2016;11(3):32136. PubMed ID: 27274418

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Burkhart SS, Morgan CD, Kibler WB. The disabled throwing shoulder: spectrum of pathology Part III: the SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation [review]. Arthroscopy. 2003;19(6):641661. PubMed ID: 12861203 doi:10.1016/S0749-8063(03)00389-X

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Sciascia A, Cromwell R. Kinetic chain rehabilitation: a theoretical framework. Rehabil Res Pract. 2012;2012:853037. PubMed ID: 22666599

  • 40.

    McMullen J, Uhl TL. A kinetic chain approach for shoulder rehabilitation. J Athl Train. 2000;35(3):32937. PubMed ID: 16558646

  • 41.

    Cools AM, Vanderstukken F, Vereecken F, et al. Eccentric and isometric shoulder rotator cuff strength testing using a hand-held dynamometer: reference values for overhead athletes. Knee Surg Sports Traumatol Arthrosc. 2016;24(12):38383847. PubMed ID: 26294055 doi:10.1007/s00167-015-3755-9

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Lewis JS, Valentine RE. Clinical measurement of the thoracic kyphosis. A study of the intra-rater reliability in subjects with and without shoulder pain. BMC Musculoskelet Disord. 2010;11:39. PubMed ID: 20193055 doi:10.1186/1471-2474-11-39

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43.

    Bennell KL, Matthews B, Greig A, et al. Effects of an exercise and manual therapy program on physical impairments, function and quality-of-life in people with osteoporotic vertebral fracture: a randomised, single-blind controlled pilot trial. BMC Musculoskelet Disord. 2010;11:36e282. PubMed ID: 20163739 doi:10.1186/1471-2474-11-36

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Bautmans I, Van Arken J, Van Mackelenberg M, Mets T. Rehabilitation using manual mobilization for thoracic kyphosis in elderly postmenopausal patients with osteoporosis. J Rehabil Med. 2010;42(2):129135. PubMed ID: 20140408 doi:10.2340/16501977-0486

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45.

    Wilk KE, Hooks TR, Macrina LC. The modified sleeper stretch and modified cross-body stretch to increase shoulder internal rotation range of motion in the overhead throwing athlete. J Orthop Sports Phys Ther. 2013;43(12):891894. PubMed ID: 24175603 doi:10.2519/jospt.2013.4990

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Tsuruike M, Ellenbecker TS. Serratus anterior and lower trapezius muscle activities during multi-joint isotonic scapular exercises and isometric contractions. J Athl Train. 2015;50(2):199210. PubMed ID: 25689561 doi:10.4085/1062-6050-49.3.80

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 47.

    Hardwick DH, Beebe JA, McDonnell MK, Lang CE. A comparison of serratus anterior muscle activation during a wall slide exercise and other traditional exercises. J Orthop Sports Phys Ther. 2006;36(12):903910. PubMed ID: 17193867 doi:10.2519/jospt.2006.2306

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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