The Influence of Glenohumeral Joint Posterior Capsule Tightness and Impingement Symptoms on Shoulder Impairments and Kinematics

Abstract

Background Posterior capsule tightness (PCT) and shoulder impingement syndrome (SIS) symptoms are both associated with altered shoulder biomechanics and impairments. However, their combined effect on kinematics, pain, range of motion (ROM), strength, and function remain unknown. Objective The purpose of this study was to determine if the combination of PCT and SIS affects scapular and humeral kinematics, glenohumeral joint ROM, glenohumeral joint external rotation strength, pain, and function differently than does either factor (PCT or SIS) alone. Design The design was a cross-sectional group comparison. Methods Participants were placed into 1 of 4 groups based on the presence or absence of SIS and PCT: control group (n = 28), PCT group (n = 27), SIS group (n = 25), and SIS + PCT group (n = 25). Scapular kinematics and humeral translations were quantified with an electromagnetic motion capture system. Shoulder internal rotation and external rotation ROM, external rotation strength, and pain and Shoulder Pain and Disabilities Index scores were compared between groups with ANOVA. Results The SIS group had greater scapular internal rotation (mean difference = 5.13°; 95% confidence interval [CI] = 1.53°–8.9°) and less humeral anterior translation (1.71 mm; 95% CI = 0.53–2.9 mm) than the other groups. Groups without PCT had greater internal rotation ROM (16.05°; 95% CI = 5.09°–28.28°). The SIS + PCT group had lower pain thresholds at the levator scapulae muscle (108.02 kPa; 95% CI = 30.15–185.88 kPa) and the highest Shoulder Pain and Disabilities Index score (∼ 44.52; 95% CI = 33.41–55.63). Limitations These results may be limited to individuals with impingement symptoms and cannot be generalized to other shoulder conditions. Conclusions Decreased ROM and lower pain thresholds were found in individuals with both impingement symptoms and PCT. However, the combination of factors did not influence scapular and humeral kinematics.

Comparison of the effectiveness of novel intervention on restricted range of motion of shoulder in young healthy subjects

“…5 Once the tightness was released, the limitation in abduction, flexion and rotation spontaneously improved. These findings are consistent with the findings of Rosa et al (2019) who observed that the association of posterior capsular tightness with the decreases the shoulder ROM. 10,26…”

“…The tightness in capsule not only affects the functional movement of hand behind the neck and back but also the shoulder range of motion. 10 The tightness in posterior capsule has been clinically observed and surgically explored. 11,12 Changes in structures around the shoulder joint occur both in persons with a sedentary lifestyle and overhead athletes.…”

Pragmatic posterior capsular stretch and its effects on shoulder joint range of motion

“…These observations are consistent with the findings reported by Rosa et al in relation to the posterior capsular tightness. 4 …”

“…These observations are consistent with the findings reported by Rosa et al in relation to the posterior capsular tightness. 4 Improvement in shoulder ROM is also reported with the intervention of the cross-body stretch, sleeper's stretch and modified stretch. The improvement associated with these stretches is less pronounced and required a longer duration of 4-8 weeks.…”

“…2 The opinion of the researchers on shoulder pathology is gradually drifting towards posterior capsular tightness as a major culprit in relation to scapular dyskinesis and subsequent pathology. [3][4][5] A cohort study reported a strong association of scapular dyskinesis and glenohumeral rotation deficits with the shoulder pain. 6 Another study reported the presence of scapular dyskinesis for 9-24 months increases the risk of shoulder pain by 43% in an athletic population.…”