Painful Athletic Injuries of the Shoulder

Jobe, Frank W.; Jobe, Christopher M.

doi:10.1097/00003086-198303000-00015

Cited by 251 publications

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“…As part of the examination, 3 tests for impingement (Neer, 35 Hawkins, 14 and Jobe 18 ) were performed as originally described, with the scapula in its natural resting posture. These tests generally have been found to have high sensitivity but low specificity, which makes them suitable for screening purposes but limits their usefulness in making a specific diagnosis.…”

Section: Methodsmentioning

confidence: 99%

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

Tate¹,

McClure²,

Kareha³

et al. 2008

J Orthop Sports Phys Ther

146

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[ research report ] t Study deSign: Two-group, repeatedmeasures design.t ObjectiveS: 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.t backgrOund: 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.t MethOdS and MeaSureS: 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.t reSultS: 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 nonimpingement 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. 27,51 In addition to the variability of findings in these studies, the magnitude of differences between those with healthy shoulders and those with pathology is typically small (in the 3° to 5° range), and it is unclear whether these differences, although statistically significant, are really of clinical significance. Because of the variability of findings in symptomatic subjects and the generally small kinematic differences found compared to asymptomatic subjects, correctly identifying patients with relevant scapular dysfunction is difficult.An alternative approach in attempting to identify those with scapular motion abnormalities is the use of symptom altering tests. The premise of these tests is to assess the magnitude of symptoms during provocation tests or shoulder movements when the scapula is in its natural position and then to repeat the provocative tests and shoulder movements with the examiner manually altering scapular motion or position. Two symptom alteration tests have been reported in the literature. The Modified Scapular Assistance test involves application of both an upward rotary and retraction force to the scapula by a single examiner in an effort to reduce pain during arm elevation. Rabin et al 40 reported satisfactory interrater reliability of this test for clinical use. The Scapula Retraction Test has been described as 1 Physical Therapist, H/S Therapy Associates, Inc, Lower Gwynedd, PA; Associate Fac...

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Section: Methodsmentioning

confidence: 99%

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

Tate¹,

McClure²,

Kareha³

et al. 2008

J Orthop Sports Phys Ther

146

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“…53 Subacromial impingement syndrome (SIS) has been considered to be one of the most common forms of shoulder pathology. 35,40,98 The syndrome is associated with pathology of 1 or more of the contents of the subacromial space. Pain and dysfunction occur when the shoulder is placed in positions of elevation, an activity that is commonplace during many sporting and vocational pursuits, and activities involved in daily living.…”

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confidence: 99%

Subacromial Impingement Syndrome: The Effect of Changing Posture on Shoulder Range of Movement

Lewis¹,

Wright²,

Green³

2005

J Orthop Sports Phys Ther

202

115

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Study Design: Random allocation of subjects into a placebo-controlled, crossover study. Objectives: To investigate the effect of changing thoracic and scapular posture on shoulder flexion and scapular plane abduction range of motion in asymptomatic subjects, and in subjects with subacromial impingement syndrome. Background: Changes in upper body posture and concomitant imbalance of the muscle system have been proposed as one of the etiological mechanisms leading to subacromial impingement syndrome. Although clinicians commonly assess posture and devise rehabilitation programs to correct posture, there is little evidence to support this practice. Methods and Materials: Selected postural, range of movement, and pain measurements were investigated in 60 asymptomatic subjects and 60 subjects with subacromial impingement syndrome, prior to and following thoracic and scapular taping intended to change their posture. Results: Changing posture had an effect on all components of posture measured (P Ͻ.001) and these changes were associated with a significant increase (P Ͻ.001) in the range of motion in shoulder flexion and abduction in the plane of the scapula. Changing posture was not found to have a significant effect on the intensity of pain experienced by the symptomatic subjects, although the point in the range of shoulder elevation at which they experienced their pain was significantly higher (P Ͻ.001). Conclusions:The findings of this investigation suggest that changing 1 or more of the components of posture may have a positive effect on shoulder range of movement and the point at which pain is experienced. J Orthop Sport Phys Ther 2005;35:72-87.

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“…The examiner applied pressure to the wrist while the patient was attempting to resist. [9] The test was considered positive if pain or weakness was observed. The full can test was performed similarly, but the thumb was pointing upwards.…”

Section: Methodsmentioning

confidence: 99%

The effect of acromioclavicular joint degeneration on orthopedic shoulder tests

Ulaşlı¹

2013

Eklem Hastalik Cerrahisi

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Physical examination of shoulder diseases remains a debate for clinicians because of questions about reliability of orthopedic shoulder tests (OST). Various studies concerning the diagnostic accuracy and reliability of OSTs with different methodologies have been published. [1][2][3] In a comprehensive review by Hegedus et al., [1] most of the clinical examination tests for shoulder diseases were found to have limited diagnostic value. The main problem seems to be limited ability of tests to address the source of pain.Amaç: Bu çalışmada akromiyoklaviküler eklem (AKE) dejenerasyonunun ortopedik omuz testleri (OOT) üzerine etkisi araştırıldı ve AKE enjeksiyonlarının omuz sıkışma tedavisindeki tamamlayıcı rolü belirlendi. Hastalar ve yöntemler: İkinci basamak bir hastanede, klinik ve radyolojik olarak omuz sıkışma sendromu tanısı konulan 62 hasta (56 kadın, 6 erkek; ort. yaş 55.8±9.3 yıl; dağılım 35-74 yıl) çalışmaya alındı. Akromiyoklaviküler eklem ve subakromiyal bölgeye iki enjeksiyon yapıldı. Hastalar başlan-gıçta ve AKE ve subakromiyal enjeksiyondan sonra OOT'ler ile (Neer, Hawkins-Kennedy, empty can, full can, eksternal rotasyon direnç, lift-off ve cross-body adduksiyon testleri) değerlendirildi. Genel ağrı skoru için görsel analog ölçeği kullanıldı. Bulgular: Hastalara iki kez enjeksiyon ve üç kez de OOT uygulandı. Akromiyoklaviküler eklem enjeksiyonu sonrası OOT'nin tamamında anlamlı bir farklılık saptandı (p<0.001). Hem AKE hem de subakromial enjeksiyon sonrasında görsel analog ölçeği skorlarında anlamlı düzelme saptandı (p<0.001). Sonuç: Rotatör kılıf lezyonu olan hastalarda, hastaya uygulanacak tedavi yaklaşımını değiştirebileceğinden, eşlik eden AKE hastalıkları dikkatle değerlendirilmelidir.Anahtar sözcükler: Akromiyoklaviküler eklem; enjeksiyon; intraartiküler; omuz sıkışma sendromu; omuz ağrısı. Objectives:This study aims to investigate the effect of acromioclavicular joint (ACJ) degeneration on orthopedic shoulder tests (OST) and to determine complementary role of ACJ injections in the treatment of subacromial shoulder impingements. Patients and methods: At a secondary care center, 62 patients (56 females, 6 males; mean age 55.8±9.3 years; range 35 to 74 years) with the clinical and radiological diagnosis of shoulder impingement syndrome were enrolled to the study. Two injections were applied to ACJ and subacromial space. Patients were assessed through OSTs (Neer, HawkinsKennedy, empty can, full can, external rotation resistance, lift-off and cross-body adduction tests) at baseline and after injection to ACJ and subacromial space. Visual analog scale was used for overall pain. Results: Two injections and three sets of OSTs were performed on the patients. A significant difference was found in the all OSTs after ACJ injection (p<0.001). Visual analog scale scores improved significantly following both ACJ and subacromial injections (p<0.001). Conclusion: Concomitant ACJ diseases should assessed carefully in the patients with rotator cuff lesions, as it may change the type of management approach.

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Painful Athletic Injuries of the Shoulder

Cited by 251 publications

References 0 publications

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

Subacromial Impingement Syndrome: The Effect of Changing Posture on Shoulder Range of Movement

The effect of acromioclavicular joint degeneration on orthopedic shoulder tests

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