Effect of specific exercise strategy on need for surgery in patients with subacromial impingement syndrome: randomised controlled study

Abstract

Objective To evaluate if a specific exercise strategy, targeting the rotator cuff and scapula stabilisers, improves shoulder function and pain more than unspecific exercises in patients with subacromial impingement syndrome, thereby decreasing the need for arthroscopic subacromial decompression.Design Randomised, participant and single assessor blinded, controlled study.

The central nervous system – An additional consideration in ‘rotator cuff tendinopathy’ and a potential basis for understanding response to loaded therapeutic exercise

“…However, when reporting favourable outcomes, recent studies have encouraged load prescription according to symptom response where pain was produced during exercise (Jonsson et al, 2005;Bernhardsson et al, 2010;Holmgren et al, 2012). Such an approach might initially appear counter-intuitive within the context of the framework described here but we suggest that quite the opposite is true.…”

“…A secondary aim is to offer a potential rationale to explain the favourable response to loaded therapeutic exercises demonstrated by previous studies (Jonsson et al, 2005;Bernhardsson et al, 2010;Holmgren et al, 2012;Littlewood et al, 2012a). These further considerations have the potential to offer a useful basis upon which to explain pain to patients and for clinicians to prescribe appropriate therapeutic management strategies.…”

Isokinetic clinical assessment of rotator cuff strength in subacromial shoulder impingement

“…Current conservative management of SSI includes generic resistance band strengthening exercises for the rotator cuff particularly shoulder external rotators (ER) (Holmgren, Bjornsson Hallgren, Oberg, Adolfsson, & Johansson, 2012;Kuhn, 2009). Exercises prescribed for SSI appear to be based on results from EMG studies and the experience and general knowledge of the physiotherapist .…”

“…Exercises prescribed for SSI appear to be based on results from EMG studies and the experience and general knowledge of the physiotherapist . (Dark et al, 2007;Holmgren et al, 2012;Michael.M. Reinold et al, 2007;Tate, McClure, Young, Salvatori, & Michener, 2010).…”

A novel cadaveric study of the morphometry of the serratus anterior muscle: one part, two parts, three parts, four?

“…Clinically, dysfunction of serratus anterior has been implicated in musculoskeletal disorders including shoulder and neck pain (Cools et al, 2014;Castelein et al, 2015). Thus in clinical practice the focus is to use exercisebased therapeutic interventions targeting serratus anterior in the rehabilitation of patients with shoulder or neck pain (Ebaugh et al, 2005;Witt et al, 2011;Holmgren et al, 2012;Worsley et al, 2013;Cools et al, 2014). However, there is no current literature to recommend effective exercises that target individual subdivisions of serratus anterior.…”