• Title/Summary/Keyword: Posterior impingement

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Complex Korean Medicine Treatment for Posterior Ankle Impingement Syndrome: Case Report (후방 발목 충돌 증후군 환자의 복합 한의진료 경과: 증례보고)

  • Park, Ji-won;Kyung, Da-hyun;Koo, Ji-eun;Bae, Jun-Hyo;Kim, Su-jin;Bae, Ji-eun
    • Korean Journal of Acupuncture
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    • v.39 no.3
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    • pp.100-106
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    • 2022
  • Posterior ankle impingement syndrome is one of the impingement syndromes characterized by posterior ankle pain that occurs during forced plantar flexion. This report presents a case of a 48-year-old PAIS patient with os trigonum syndrome accompanied by tenosynovitis of flexor hallucis longus. She was treated with complex Korean medicine to a good effect. The Numeric Rating Scale and the EuroQol 5-Dimension 5-Level were used to measure the impact of Korean medicine on the patient's pain and quality of life. Decreased NRS and increased EQ-5D-5L scores reflected improvement in her symptoms within 25 days. This study suggests complex Korean medicine treatment for PAIS may be beneficial for alleviating pain and improving quality of life.

Posterior Internal Impingement of the Shoulder in Baseball Players -Preliminary Report of 5 Cases Study- (야구 선수에서의 견관절 내부 후방 충돌 -5예에 대한 예비보고-)

  • Kim, Young-Kyu;Choi, Kwang-Woon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.1
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    • pp.36-42
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    • 2005
  • Purpose: To investigate the arthroscopic findings, and to evaluate the clinical outcomes of the treatment of posterior internal impingement of the shoulder in baseball players. Materials and Methods: We followed up 5 cases who were diagnosed as posterior internal impingement for the mean 15 months. All of the cases complained of the pain in the posterior shoulder at late cocking, and were positive in the relocation test added by hyper-horizontal abduction at $120^{\circ}$ abduction of the arm. We sutured posterior labral tear and SLAP lesion arthroscopically, and conducted debridement for rotator cuff. Three cases were performed of anterior capsular plication and the other two were performed of thermal capsular shrinkage. Pain, range of motion, and level of return to sports activity were assessed for the results. Results: As to the arthroscopic findings, all the five cases showed the fraying in posterosuperior labrum, and two of them was accompanied with the flap tear in posterosuperior labrum and the other one was accompanied with type 2 SLAP lesion. All the cases showed the fraying in supraspinatus, and one case showed partial tear. Meanwhile, in all the cases, the rotator cuff was impinged to the labrum at $90^{\circ}{\sim}120^{\circ}$ of abduction and external rotation. As to the postoperative results, all the cases did not complain of pain or instability while pitching, and the competition was recovered to be the mean 88%($80{\sim}100%$) of that before the injury. Conclusion: Definite diagnosis for the posterior internal impingement would be possible through arthroscopic examination. Favorable outcomes could be obtained with capsular plication or shrinkage for anterior microinstability and stretching exercise for posterior capsule tightness inducing the internal impingement.

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The Effects of Joint Mobilization and Stretching on the Muscle Activity and Internal Rotation of Shoulder Joint in Patients With Impingement Syndrome With Posterior Shoulder Tightness (관절가동술과 스트레칭이 어깨후방뻣뻣함을 가진 충돌증후군의 어깨관절 근활성도와 안쪽돌림에 미치는 영향)

  • Moon, Gui-do;Lim, Jin-yong;Kim, Tae-ho;Lee, Dong-woo
    • Physical Therapy Korea
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    • v.27 no.1
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    • pp.38-44
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    • 2020
  • Background: Posterior shoulder tightness, which is a problem mainly seen in patients with shoulder impingement syndrome, disrupts the scapulohumeral rhythm between the humerus and scapulae. Objects: The aim of this study was to compare the effects of joint mobilization and stretching on shoulder muscle activity and internal rotation range of motion (ROM) of the glenohumeral joint in patients with impingement syndrome with posterior shoulder tightness. Methods: The research subjects included 22 in-patients with impingement syndrome with posterior shoulder tightness. They were randomly divided into two groups: one group (12 patients) was treated with joint mobilization and the other group (10 patients) was treated with stretching for the posterior shoulder tightness. Each treatment was performed five times a week for two weeks, and there were 15 sessions for each treatment. The ROM of the internal rotation and muscle activities of shoulder joint were evaluated pretest and posttest in each group. Electromyography data were collected from the upper, middle, and lower trapezius and serratus anterior during shoulder abduction of 90°, 120°, and 150°. Results: Both the joint mobilization and stretching groups showed significant decreases in muscle activity in the upper, middle, and lower trapezius on the posttest (p < 0.05). There was a significant difference in serratus anterior at 150° (p < 0.05), but there was no significant difference between group in post-hoc analysis (p > 0.025). The internal rotation ROM was significantly increased in the stretching group compared to that in the joint mobilization group (p < 0.025). Conclusion: This study found that both joint mobilization and stretching for posterior shoulder tightness were effective in muscle activity during arm abduction, also in order to increase internal rotation ROM of shoulder joint, stretching was effective in patients with impingement syndrome with posterior tightness.

Anterior Impingement Syndrome of the Ankle (발목 관절의 전방 충돌 증후군)

  • Sung, Ki-Sun
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.4
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    • pp.195-200
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    • 2011
  • Impingement syndrome of the ankle is defined as painful mechanical limitation of full ankle movement secondary to osseous and/or soft tissue abnormality. These conditions occur more commonly in active people and athletes probably because recurrent subclinical injury is an important factor in development of the syndrome. Impingement syndromes of the ankle are categorized according to their anatomical site around the ankle joint. Anterolateral, anterior and posterior impingement has been extensively described in the orthopaedic literature. The purpose of this article is to review the clinical feature and management of anterior impingement syndrome of the ankle.

Ankle Impingement Syndrome (족관절 충돌 증후군)

  • Choi, Gi-Won;Choi, Woo-Jin;Lee, Jin-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.16 no.1
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    • pp.19-25
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    • 2012
  • The ankle impingement syndrome is an established cause of ankle dysfunction. In most cases with suspected ankle impingement, the diagnosis can be possible on the basis of mechanism of injury involved and the clinical examination. An appropriate imaging study should be selected where clinical doubt about the exact diagnosis exists. Radiography plays an important role in the initial assessment of these conditions, especially in anterior and posterior impingement. Magnetic resonance arthrography seems to be the most accurate means of assessing the capsular abnormalities present in anterolateral and anteromedial impingement and for confirmation of possible concomitant injury. Surgical treatment can be considered for the patients who did not respond to conservative treatment for more than 6 months, and has a low complication rate and a high level of success.

Internal Impingement of the Shoulder (내적 충돌 증후군)

  • Kim, Yang-Su
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2007.11a
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    • pp.153-161
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    • 2007
  • 견관절의 ABER position에서 posterosuperior rotator cuff 가 posterior glenoid에 contact 하여 internal impingement가 일어나는 현상은 운동선수가 아닌 일반인에게도 발생하는 physiologic phenomenon이며 과도한 반복 동작으로 인하여 증상이 발현한다. Internal impingement는 증상이 모호할 뿐만 아니라 견관절 내 여러 병소가 함께 존재하기 때문에 각각의 pathology에 대한 자세하고 정확한 evaluation이 필수적이다. 아직 controversy가 있지만 internal impingement의 pathologic factors로서는 anterior capsular laxity (true anterior laxity), posteroinferior capsular tightness (pseudo anterior laxity)와 이로 인한 glenohumeral internal rotation deficit (GIRD), 그리고 SICK scapula syndrome (scapular dyskinesis) 등으로 요약할 수 있다. 진단은 주로 병력 청취와 신체 검사로 내려지며 ultrasonogram, MRA등으로 확진한다. Sleeper stretching exercise 등과 같은 보존적 치료에 반응이 좋지만 6개월간의 재활 치료에도 호전이 없다면 증상과 직접 관련된 주 병소(appropriate pathology)를 찾아 이에 대한 적절한 수술이 이루어져야 한다.

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Treatment of Os Trigonum Syndrome using Subtalar Arthroscopy (A Case Report) (거골하 관절경을 이용한 Os Trigonum Syndrome의 치료(1예 보고))

  • Ahn, Jae-Hoon;Baek, Chang-Hyun;Lee, Kwang-Won;Kim, Seung-Kwon;Choy, Won-Sik
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.267-270
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    • 2006
  • Os trigonum syndrome is a clinical disorder characterized by posterior ankle pain which occurs in excessive plantar flexion. The pain is elicited by the impingement of os trigonum between the calcaneus and the posterior edge of tibial plafond. Mostly, symptoms can be improved with nonsurgical management, however surgery is required for refractory cases. We report of a case of os trigonum syndrome in a female ballet dancer, which was successfully treated with subtalar arthroscopic excision of os trigonum.

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Arthroscopic Treatment of Coronoid Impingement in Stiff Elbow

  • Lee Yong Geol
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 1999.03a
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    • pp.38-40
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    • 1999
  • $\cdot$ Arthroscopic management is the effective method with acceptable results for coronoid impingement of stiff elbow contributing to the functional improvement and pain relief. $\cdot$ The functional improvement and pain relief seem to be affected by the severity of a degenerative change of the elbow joint. $\cdot$ Excision of coronoid process is required in a marked limitation of further flexion in addition to deeping of the coronoid fossa and anterior capsular release. $\cdot$ Excision of olecranon tip or posterior capsular release are effective method in severe flexion contracture.

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