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Saurabh Sharma and M. Ejaz Hussain

Key Points ▸ The Hindi SPADI can be recommended for the evaluation of athletes with shoulder impingement syndrome (SIS). ▸ The Hindi SPADI is a useful tool for clinicians to assess the impact of rehabilitation in SIS athletes. Shoulder pathologies have significant health care costs. The incidence

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Yi-Fen Shih, Ya-Fang Lee and Wen-Yin Chen

Shoulder impingement syndrome (SIS) is defined as an impingement of the subacromial tissues, caused by the colliding humeral head and acromion during arm elevation. It has been reported as the most common cause of shoulder pain and disability. 1 , 2 The scapula provides the proximal stability for

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Fahimeh Kamali, Ehsan Sinaei and Maryam Morovati

our knowledge, this is the first study to compare the direct and remote effects of DN on pain and discomfort of UT in patients with shoulder impingement syndrome. It was hypothesized that applying DN in ISP MTrP would improve the symptoms of our participants, as effectively as the direct application

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Joseph B. Myers

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.

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Alya H. Bdaiwi, Tanya Anne Mackenzie, Lee Herrington, Ian Horlsey and Ann Cools

Context:

Compromise to the acromiohumeral distance (AHD) has been reported in subjects with subacromial impingement syndrome when compared with healthy subjects. In clinical practice, patients are taped with the intention of altering scapular position and influencing the AHD. However, research to determine the effects of taping on AHD is exiguous.

Objectives:

To evaluate the effect of ridged taping techniques to increase posterior scapular tilt and upward scapular rotation on the AHD.

Design:

1-group pretest/posttest repeated-measures design.

Setting:

Human performance laboratory.

Participants:

20 asymptomatic participants (10 male and 10 female) age 27 y (SD 8.0 y).

Intervention:

Ridged tapping of the scapula into posterior tilt and upward scapular rotation.

Main Outcome Measure:

Ultrasound measurement of the AHD.

Results:

AHD increased significantly after rigid tape application to the scapula (P < .003) in healthy shoulders in 60° of passive arm abduction.

Conclusion:

Taping techniques applied to the scapula had an immediate effect of increasing the AHD in healthy shoulders in 60° of passive arm abduction. Results suggest that taping for increasing posterior scapular tilt and increasing scapular upward rotation can influence the AHD and is a useful adjunct to rehabilitation in patients with subacromial impingement syndrome.

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Amee L. Seitz, Michael Reinold, Robert A. Schneider, Thomas J. Gill and Charles Thigpen

Context:

Differences in 3-dimensional (3D) scapular motion have been reported between healthy baseball position players and healthy nonoverhead athletic controls, as well as players diagnosed with shoulder impingement syndrome. These alterations are theorized to be the result of adaptations due to the demands of repetitive throwing. However, comparisons between the throwing and nonthrowing shoulders are commonly used to infer normal motion.

Objective:

The purpose of this study was to compare 3D scapular kinematics between the throwing and nonthrowing shoulders in asymptomatic professional male baseball pitchers.

Design:

Cross-sectional study.

Setting:

Laboratory.

Participants:

45 asymptomatic professional baseball pitchers participating without restrictions during preseason training.

Interventions:

An electromagnetic tracking system was used to assess 3D scapular orientation at rest and during weighted (2.3-kg) shoulder flexion across discrete humeral-flexion angles (rest, 30°, 60°, 90°, 120°, and maximum).

Main Outcome Measure:

3D scapular upward/downward rotation (UR/DR), anteroposterior (AP) tilt, and internal/external rotation (IR/ER). Separate mixed-model ANOVAs (Side × Angle) for each scapular motion were used to compare the throwing and the nonthrowing shoulder across all angles.

Results:

There were significant side-to-side differences with scapular UR/DR (P < .001), AP tilt (P < .001), and IR/ER (P < .001). The throwing scapula displayed greater mean UR (increase = 3.6°, SE = 0.50) and anterior/posterior tilt (increase = 2.1°, SE = 0.60) and less mean IR (decrease = 2.1°, SE = 0.66) than the nonthrowing shoulder averaged across all arm angles.

Conclusions:

In asymptomatic professional pitchers, the throwing shoulder’s scapular position differs across all arm angles from that of the nonthrowing shoulder, but the motion does not differ. Scapular asymmetry that is consistent throughout arm elevation may be indicative not of pathology but, potentially, of a normal adaptation of the pitching shoulder.

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Mark K. Timmons, Chuck A. Thigpen, Amee L. Seitz, Andrew R. Karduna, Brent L. Arnold and Lori A. Michener

Context:

The literature does not present a consistent pattern of altered scapular kinematics in patients with shoulder-impingement syndrome (SIS).

Objectives:

To perform meta-analyses of published comparative studies to determine the consistent differences in scapular kinematics between subjects with SIS and controls. In addition, the purpose was to analyze factors of the data-collection methods to explain the inconsistencies in reported kinematics. The results of this study will help guide future research and enable our understanding of the relationship between scapular kinematics and SIS.

Evidence Acquisition:

A search identified 65 studies; 9 papers met inclusion criteria. Sample sizes, means, and SDs of 5 scapular-kinematic variables were extracted or obtained from each paper’s lead author. Standard difference in the mean between SIS and controls was calculated. Moderator variables were plane of arm elevation, level of arm elevation (ARM) and population (POP).

Evidence Synthesis:

Overall, the SIS group had less scapular upward rotation (UR) and external rotation (ER) and greater clavicular elevation (ELE) and retraction (RET) but no differences in scapular posterior tilt (PT). In the frontal plane, SIS subjects showed greater PT and ER, and in the scapular plane, less UR and ER and greater ELE and RET. There was also greater ELE and RET in the sagittal plane. There was less UR at the low ARM and greater ELE and RET at the high ARM with SIS. Athletes and overhead workers showed less UR, while athletes showed greater PT and workers showed less PT and ER. The general population with SIS had greater ELE and RET only.

Conclusions:

Subjects with SIS demonstrated altered scapular kinematics, and these differences are influenced by the plane, ARM, and POP. Athletes and overhead workers have a different pattern of scapular kinematics than the general population. The scapular plane is most likely to demonstrate altered kinematics. These factors should be considered when designing futures studies to assess the impact of altered kinematics in patients with SIS.

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the student develop confidence and take on responsibility. a. True b. False 17. Of the 80 male overhead athletes in the shoulder impingement syndrome Research Report by Sharma and Hussain, what sport was most represented? a. badminton b. basketball c. cricket d. volleyball 18. In this study

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Hio Teng Leong and Siu Ngor Fu

partial or complete tears that is related to RC tendons and associated tissues such as long head of the biceps tendinopathy, subacromial bursitis, and shoulder impingement syndrome. 2 Clinical symptoms include pain, weakness, and disability during arm elevation, and affects health and quality of life by

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Elif Turgut, Irem Duzgun and Gul Baltaci

shoulder impingement syndrome . J Orthop Sports Phys Ther . 1998 ; 28 ( 1 ): 3 – 14 . PubMed doi:10.2519/jospt.1998.28.1.3 10.2519/jospt.1998.28.1.3 9653685 11. Walther M , Werner A , Stahlschmidt T , Woelfel R , Gohlke F . The subacromial impingement syndrome of the shoulder treated by