Relationship Between Shoulder Impingement Syndrome and Thoracic Posture

Abstract

Background Shoulder impingement syndrome (SIS) is the most common form of shoulder pain and a persistent musculoskeletal problem. Conservative and invasive treatments, aimed at the shoulder joint, have had limited success. Research suggests shoulder function is related to thoracic posture, but it is unknown whether thoracic posture is associated with SIS. Objective The objective of this study was to investigate whether there is a relationship between SIS and thoracic posture. Design This was a case control study. Methods Thoracic posture of 39 participants with SIS and 39 age-, gender-, and dominant arm-matched controls was measured using the modified Cobb angle from a standing lateral radiograph. Thoracic range of motion (ROM) was also measured using an inclinometer. Between-group differences were compared using t tests. The relationship between thoracic posture and thoracic ROM was determined with linear regression. Results Twenty women and 19 men with SIS (mean age = 57.1 years, SD = 11.1) and 39 age-matched, gender-matched, and dominant arm-matched controls (mean age = 55.7years, SD = 10.6) participated. Individuals with SIS had greater thoracic kyphosis (mean difference = 6.2o, 95% CI 2.0–10.4) and less active thoracic extension (7.8o, 95% CI = 2.2–13.4). Greater thoracic kyphosis was associated with less extension ROM (ie, more flexion when attempting full extension: β = 0.71, 95% CI = 0.45–0.97). Limitations These cross-sectional data can only demonstrate association and not causation. Both radiographic measurements and inclinometer measurements were not blinded. Conclusion Individuals with SIS had a greater thoracic kyphosis and less extension ROM than age- and gender-matched healthy controls. These results suggest that clinicians could consider addressing the thoracic spine in patients with SIS.

Acromiohumeral distance and supraspinatus tendon thickness in people with shoulder impingement syndrome compared to asymptomatic age and gender-matched participants: a case control study

“…This study was part of a cross-sectional study investigating the possible relationship between thoracic posture (measured from a single lateral radiograph) and SIS [ 31 ]. Participants recruited ( n = 78) were between 40 and 80 years of age, given the increase in prevalence of SIS from the age of forty [ 10 – 12 ].…”

“…The sample size of this study was determined as the number of participants required for the case-control study investigating differences in posture between individuals with and without SIS [ 31 ]. A 5 degree difference in modified Cobb angle between groups (SIS and healthy controls), a standard deviation of 10 degrees (estimated from Katzman et al (2013) and Fon et al (1980) [ 33 , 34 ]) established 34 participants per group to achieve 80% power with a 5% level of significance.…”

Mechanical Hyperalgesia but Not Forward Shoulder Posture Is Associated with Shoulder Pain in Volleyball Players: A Cross-Sectional Study

“…The results of this study appeals to the fact that shoulder position is not a key factor or a clear contributor to shoulder pain [ 11 , 22 ]. These results are in agreement with the findings of Ozunlu et al [ 23 ] and Ribeiro et al [ 23 ] Ozunlu et al [ 23 ] showed that asymmetric scapular posture in volleyball players might be normal and not necessarily related to injury and Ribeiro A et al [ 23 ] reported that scapular asymmetry may be normal and it should not be automatically considered as a pathological sign in throwing athletes.…”

“…This can lead to some postural alterations such as an antepulsion of the shoulder can alter the mechanosensitivity of different tissues, thus decreasing their tolerance to mechanical stress even if it does not provoke a nociceptive response [ 10 ]. A recent study adds data on this association by concluding that individuals with shoulder impingement syndrome had a greater thoracic kyphosis and less extension movement than age- and gender-matched healthy controls [ 11 ]. For all these reasons, more studies are needed in the sports population to observe whether these types of associations or relationships exist and what clinical implications they may have.…”

Application of Ultrasound Diagnosis Technology Based on Statistical Analysis in Rehabilitation Treatment of Shoulder Sports Injuries

“…According to the statistical results of relevant clinical research data, the rotator cuff injury accounts for about 16.9% to 40.3% of the shoulder joint's various related diseases. Attention to rotator cuff injuries and early treatment is of great significance in preventing rotator cuff joint disease [ 5 ]. Through timely and correct diagnosis and early treatment, other joint and severe diseases caused by reduced shoulder joint movement function can be reduced.…”