• The Journal of Korean Orthopaedic Ultrasound Society
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• v.7 no.1
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• pp.20-27
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• 2014

Purpose: The purpose of this study was to evaluate coracohumeral distance (CHD) in patients with or without subcoracoid impingement with hypothesis that patients with subcoracoid impingement would have narrower CHD. Materials and Methods: One hundred twenty-four patients with subacromial impingement were evaluated. The subjects with subcoracoid impingement which was affirmed clinically and confirmed by ultrasound guided subcoracoid injection (n=28) was compared with patients with subacromial impingement only (n=96). Patients with stiffness and rotator cuff tear were excluded. Absolute CHD was measured on magnetic resonance imaging (MRI) axial images and on ultrasound with the humerus in neutral position and internal rotation. Also relative ratio of distance difference (RRDD) defined as the difference of CHD in neutral position and internal rotation compared with absolute CHD in neutral on ultrasound was also measured. Results: The distance measured in neutral position was similar between US imaging and MRI (p>0.05) and both measurements did not have significant difference between the two groups (p>0.05). On ultrasound, the difference in CHD in internal rotation between the two groups nearly met the level of significance (p=0.07). No significant difference of CHD difference in two humeral positions was seen between the two groups. However, RRDD value was significantly greater in subcoracoid impingement group (p<0.05). Conclusion: No significant difference of CHD was seen between the subcoracoid impingement group and the control group. RRDD value was greater in subcoracoid impingement group suggesting that individualized coracohumeral distance in internal rotation should be taken into account when assessing patients with subcoracoid impingement.

• Journal of Korean Orthopaedic Sports Medicine
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• v.9 no.2
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• pp.104-108
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• 2010

Purpose: To evaluate the correlation between Korean Shoulder Scoring System and Isokinetic muscle strength test for allowance of the return to unrestricted activities after rotator cuff disease treatment. Materials and Methods: This study examined 59 patients with impingement syndrome and 36 patients with rotator cuff tear. KSS and isokinetic muscle strength were analyzed and we sought to evaluate the correlation between total score or each functional parameter scores of KSS and isokinetic muscle strength deficit with Pearson's correlation test. Results: We found a weak negative correlation between and the total KSS score and the endurance test as well (r<0.346). The correlation between the manual muscle test of KSS and isokinetic strength deficits was not significant (p>0.05). Conclusion: The isokinetic muscle strength deficit had a weak correlarion between total score or the edurance test of KSS. Our results suggest that the Isokinetic muscle strength test may be needed for return to normal activity after treatment.

• Journal of Korean Medicine Rehabilitation
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• v.33 no.2
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• pp.77-85
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• 2023

Objectives The aim of this study is to retrospectively evaluate the shoulder lesions in patients experiencing shoulder pain through the use of musculoskeletal ultrasound during Korean medicine intervention treatments. Methods A total of 20 cases were collected, including biceps tendinitis (n=4), calcification (n=3), SASD bursitis (n=4), partial tear (n=2), full-thickness tear (n=1), tendinopathy (n=5), and impingement syndrome (n=1). Musculoskeletal ultrasound was used by Korean medicine doctors to perform real-time scanning and to explain the patient's condition during treatment sessions. Results The use of musculoskeletal ultrasound allowed Korean medicine doctors to perform treatments such as pharmacoacupuncture, acupotomy, and acupuncture more safely and effectively. Patients were able to better understand their conditions through real-time imaging and explanations provided by the doctors. Conclusions Musculoskeletal ultrasound has the potential to enhance the safety and efficacy of Korean medicine intervention treatments for patients with shoulder pain. Institutional or governmental support is needed to further promote the use of medical devices by Korean medicine doctors, ultimately leading to an increase in cases and clinical evidence.

• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.79-86
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• 2012

The conservative treatment for impingement and rotator cuff tear includes rest, nonsteroidal anti-inflammatory drugs (NSAIDs), local steroid injection and physiotherapy depending on the purpose to relieve the pain and inflammation, in addition, stretching exercise to recover flexibility and strengthening exercise to recover the function could be used. When these conservative treatments are divided into multiple steps, the first one contains pain relief, modification of daily activity and stretching exercise. Second step includes strengthening exercise of the anterior/posterior cuff and peri-scapular muscles and eventually. The third step includes training program to return to job, housework and hobby activities and maintain. Thus, the key of these step wise approach for the treatment of impingement and rotator cuff tear is exercise program. Understanding of various exercise program and apply to the patients properly is most important for the conservative treatment of impingement and cuff tear.

• Journal of Korean Orthopaedic Sports Medicine
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• v.7 no.2
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• pp.67-74
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• 2008

Repetitive overhead throwing exerts significant mechanical stress on the elbow joint. Pitching in baseball, serving in tennis, spiking in volleyball, passing in American football and launching in javelin-throwing can all produce elbow pathology by forceful valgus stress, with medial stretching, lateral compression and posterior impingement. This stress can lead to developmental anatomic changes in the young thrower. Asymptomatic pathology in the shoulder and elbow joint is prevalent and, with overuse, can progress to disabling injury. Joint injury occurs as a result of the body's inability to properly coordinate motion segments during the pitching delivery, leading to further structural damage. The implications of acute and overuse injuries and the possibility of permanent damage should be understood by parents, coaches and the athletes. Proper understanding of the intrinsic and extrinsic risk factors that could lead to elbow injuries is thus required. Measures to prevent elbow injuries should include proper coaching, warm-up, medical expertise and protective gear. Injury prevention and rehabilitation should center on optimizing pitching mechanics, core strength, scapular control, and joint range of motion.

• The Journal of Korean Physical Therapy
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• v.36 no.2
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• pp.71-77
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• 2024

Purpose: The prolonged use of digital devices has led to the widespread adoption of poor postures, particularly rounded shoulder posture (RSP), associated with shoulder impingement and pain. This study investigates the effects of neuromuscular electrical stimulation (NMES) on RSP in healthy adults. Methods: Thirty adults with RSP were randomly assigned to NMES only, exercise only, or NMES with exercise groups. NMES was applied to the lower trapezius, which was the target muscle in this study, for a total of 2 weeks, 5 times per week, 20 minutes per session. The exercise program included pectoralis minor stretching, wall-slide exercise, dynamic hug exercise with band, and Brugger stretching for upper body with band, which were performed for a total of 2 weeks, 5 times per week, 20 minutes per session. Outcome measures, including the Supine Method (SM) for posture and surface electromyography (EMG) of the lower trapezius for muscle activity, were assessed before the intervention, after 5 sessions, and after 10 sessions. Results: All the groups showed significant changes in the SM and % maximal voluntary isometric contraction (%MVIC) over time (p<0.05). The NMES group had significantly reduced SM at 1 week, while the exercise and combined groups had reduced SM at 2 weeks (p<0.017). All the groups had increased %MVIC at 2 weeks (p<0.017), with no significant differences observed between groups. Conclusion: NMES alone can be as effective as exercise in improving RSP. NMES combined with exercise also showed positive outcomes, thus offering diverse treatment options for this condition.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.7
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• pp.380-386
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• 2019

Shoulder joint pain is a very common musculoskeletal disorder, in which about 20 percent of adults experience it more than once in their lives. In this study, an objective assessment was made that subacromial space was increased by pectoralis minor stretching exercise, which has a positive effect on impingement syndrome and shoulder pain. Also, This study examined the effects on pectoralis minor length(PML) and acromio-humeral distance(AHD) following pectoralis minor self-stretching exercise in normal adults. In this study, a total of 30 subjects were recruited and randomly divided into a self-stretching exercise group(n=15) and manual stretching exercise group(n=15) to compare the immediate effects of treatment. Studies have shown that both groups have significantly increased both PML and AHD within the group(p<.05). There was no statistically significant difference in the comparison between the groups(p>.05). The results suggest that self-stretching exercise can be recommended as a treatment method for impingement syndrome and prevention of shoulder disease.

• Journal of the Korean Arthroscopy Society
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• v.13 no.1
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• pp.34-38
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• 2009

Purpose: To evaluate the association of subacromial bursa inflammation with acromial shape and shoulder pain in subacromial impingement syndrome. Materials and Methods: 24 cases with subacromial impingement syndrome were reviewed. Eighteen patines were males and six females(mean age: 58.3 yrs). During arthroscopic operation, the specimens were taken from subacromial bursa with arthroscopic knife($1{\times}1$ cm size). The shape of acromion were classified according to Bigliani grading system. The shoulder pain of patients was graded with visual analog scale (VAS). The grade of inflammation was classified to the pathological three grade system (mild, moderate, severe) by pathohistological 8 factors. Results: Of total 24 cases, 9 cases were the pathological grade I and 15 cases were grade II. None was grade III. In the 9 cases of pathological grade I, 6 cases were the radiologic grade II of acromial shape and 3 cases were grade III. In the 15 cases of pathological grade II, 5 cases were the radiologic grade II and 10 cases were grade III. The VAS was 7 point at pathological grade I and 8 point at grade II. As the statistical analysis, the pathological grade of subacromial bursa was associated with acromial shape (p<0.05), but not associated with pain of patient (p>0.05). Conclusion: Our study suggests that pathological grade of subacromial bursa inflammation was associated with acromial shape. But pathological grade of subacromial bursa inflammation was not associated with shoulder pain of patients.

• The Journal of Korean Physical Therapy
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• v.30 no.1
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• pp.8-13
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• 2018

Purpose: The present study was to investigate effects of scapular position and pain on a trunk stabilization exercise with gym ball for patients with arthroscopic rotator cuff repair. Methods: Subjects were patients after 2 weeks of rotator cuff repairs. Subjects were randomly assigned to conservative treatment group (CTG, n=10) or trunk stabilization with gym ball group (SBG, n=10), and participated one of those groups for 2 weeks. Measurements about pain and scapular position were assessed in before and after treatment programs. Results: Pain reduced in both rest and night in SBG compared to CTG. In the case of scapular position, decreased scapular retraction (increased protraction) was found in CTG and vice versa in SBG. Reduced scapular anterior tilting was also found on SBG. Conclusion: The present study showed that early performed trunk stabilization with gym ball could bring a scapular alignment that increases subacromial space and reduces pain. This suggests early trunk stabilization with gym ball programs to restore shoulder functions for patients with rotator cuff repair.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.3
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• pp.369-378
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• 2013

PURPOSE: The purpose of present study was to ascertain how the activity of the serratus anterior muscle, the upper trapezius muscle and the pectoral major muscle was affected while the upper arm was being flexed at 70, 90 and 110 degrees respectively in a closed kinetic chain exercise (wall push up plus) and an open kinetic chain exercise (static hug). METHODS: Sixteen healthy young men subjects participated in the study. Surface electromyography (EMG) data were collected from the dominant-side muscles during a closed kinetic chain exercise and an open kinetic chain exercise. The activity of each muscle was measured quantitatively, and by the use of the two-way repeated ANOVA, the data were compared with each other according to exercises and shoulder flexion angles. RESULTS: Results indicated that the closed kinetic chain exercise did not interact with the open kinetic chain exercise (p>.05). In both the closed kinetic chain exercise and the open kinetic chain exercise, the activity of the serratus anterior muscle became different significantly according to angles (p<.05). Its activity increased in order of 70, 90 and 110 degrees (p<.05). In both exercises and all angles, muscle activity was significantly higher in the serratus anterior muscle than in the upper trapezius muscle and the pectoral major muscle (p<.05). CONCLUSION: The above results show that there is a need to selectively control the exercise stress of the serratus anterior muscle in the case of the patients with the shoulder impingement syndrome characterized by the winged scapula, insufficient scapular protraction and upward rotation.