• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.219-228
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• 2022

Purpose : The purpose of this study was to suggest a more effective method by comparing the effects of changes in pain intensity, muscle strength, and athletic performance after applying a 6-week eccentric training program (ET-MWM) or concentric training program (CT-MWM) with MWM for high school baseball players with shoulder internal impingement (SII). Methods : A total of 75 participants were randomly assigned to each group and divided into two groups, "ET-MWM group (n=35)" and "CT-MWM group (n=32)" according to the intervention method. Pain intensity, muscle strength (external rotation, internal rotation), and athletic performance were first measured before the intervention, and after the intervention 3 times a week for a total of 6 weeks, both groups were re-measured in the same way. Visual analog scale (VAS) was used for pain intensity, biodex dynamometer for muscle strength (60 °/sec.), and Kerlan-Jobe orthopedic clinic shoulder & elbow score (K-KJOC) for athletic performance. Results : As a result of analyzing the homogeneity of the pre-intervention characteristics and initial measurement variables of the study subjects, there was no significant difference between the two groups in all variable values. Pain intensity (VAS) was significantly reduced in the ET-MWM group than in the CT-MWM group (p<.05). In addition, the maximum muscle strength of external rotation & internal rotation of the shoulder (60 °/sec.) and athletic performance (K-KJOC) were significantly increased in the ET-MWM group than in the CT-MWM group (p<.05). Conclusion : Compared with the CT-MWM training program, the ET-MWM training program reduced shoulder joint pain and further increased the muscle strength required for throwing motion in high school baseball players. As the result showed better athletic performance improvement, the ET-MWM training program can be clinically recommended as a more effective intervention.

• 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.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.2 no.2
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• pp.68-73
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• 2009

Purpose: We retrospectively studied the outcomes of the shoulder impingement syndrome for the treatment of the ultrasound-guided subacromial bursal steroid injection. Materials and Methods: Sixty-six shoulders of sixty-two patients with shoulder impingement syndrome treated from March, 2006 to April, 2009 were involved in this study. All cases underwent standardized, nonoperative treatment protocol consisting of 5~12 MHz high resolution ultrasound-guided local steroid injection into the subacromial bursa in modified Crass position. The shoulder range of motion, VAS score and impingement signs were evaluated during the initial and 1year visits. After injection, shoulder elevation exercise was encouraged. Statistical analysis with ANOVA model and Tukey's post-hoc test with the significance level at 5% were performed using SAS program. Results: All cases showed improved range of motion without limitation of shoulder function at immediate post-injection, 6-week, 3-month and 1year visits. The average VAS score at one year follow-up decreased to 2.85 from 6.47 before injection. In all cases the impingement signs became negative immediate after injection. However, 6 cases showed positive impingement signs after 6-week, which became negative after reinjection. The range of motion and VAS score were improved at one-year follow-up compared to initial visit (p<0.0001). No complication was noted at all follow-up period. Conclusion: Ultrasound-guided subacromial steroid injection alleviated the need of surgery, because it was successful in all our cases to improve pain and function of the shoulders until one year follow-up period.

• Journal of Korean Medicine Rehabilitation
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• v.29 no.3
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• pp.173-182
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• 2019

This study is to report the effectivenes of Meridian-Test (M-test) in 2 cases on shoulder diseases. The M-test was applied to one patient diagnosed with as impingement syndrome and one patient diagnosed with tear of supraspinatus tendon. The changes in numeral rating scale and range of motion were identified to assess the progress of the treatment. After three times treatments, In example 1, the pain decreased from 6 to 0.5 and the range of flexion and abduction increased from $150^{\circ}$ to $180^{\circ}$. In example 2, the pain decreased from 6.5 to 1, and the range of shoulder flexion increased from $120^{\circ}$ to $170^{\circ}$, while the range of abduction increased from $90^{\circ}$ to $170^{\circ}$. Based on the above results, it would be effective to apply M-test to treat shoulder diseases in these two cases.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.280-285
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• 2010

Purpose: Coracoid impingement syndrome refers to subscapularis impingement between the coracoid process and lesser tuberosity of the humerus, and pain may occur when the arm is positioned in forward flexion, internal rotation and adduction. This position is common for archers. Material and methods: A female archer with coracoid impingement syndrome that was uncontrolled by conservative therapy underwent arthroscopic subcoracoid decompression. At the 20th postoperative month of follow up, she complained of painful rotator interval widening and so she underwent arthroscopic rotator interval plication. Results: At the postoperative 6th month of follow up after the second operation, she showed no pain and good functional results, and she returned to competing as an archer. Conclusion: We have reported here on a case of successful treatment of painful rotator widening after subcoracoid decompression in an elite archer.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.93-98
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• 1999

Purpose: The purpose of this study was to analyze the prognostic factors for arthroscopic subacromial decompres­sion and rotator cuff debridement in impingement syndrome. Materials and Methods : Arthroscopic subacromial decompression with or without rotator cuff debridement was performed in 46 cases of 44 consecutive patients with either stage n or stage ill impingement syndrome. The patients were classified by Neer's stage and size of tear according to the criteria of Cofield. The results were assessed with UCLA rating scale. We used repeated measures ANOVA and Chi-square test to assess correlation between the results and six variables including stage, rotator cuff tear size, age at the operation, duration of symptom, throwing sports activity, and trauma history. The follow-up period averaged 53 months(range, 27 to 92 months). Results: Lower stage by Neer's stage was correlated with higher postoperative scores and with significant difference between preoperative and postoperative scores of UCLA rating scale. However, other factors did not show significant influence upon the results. The patients with complete rotator cuff who showed satisfactory results after procedures were older and had shorter symptom duration, small cuff size. Conclusions : In patients with impingement syndrome treated by arthroscopic debridement and subacromial decompression, superior results were obtained when belonged to a lower Neer stage and when the rotator cuff was only partially tom. In cases with complete rotator cuff tear, higher success rates were obtained with smaller tear sizes. Age at operation, duration of symptoms, throwing athlete, traumatic tear did not affect the results.

• Clinics in Shoulder and Elbow
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• v.2 no.1
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• pp.28-34
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• 1999

Purpose: We studied magnetic resonance imaging of acromion morphology and superior displacement of the humeral head in the patients with diagnosis of rotator cuff impingement syndrome, and also documented the relationship of type Ⅲ acromion to the rotator cuff tear. Materials and Methods: We reviewed retrospectively 40 patients(40 shoulders) who had arthroscopic treatment for the diagnosis of stage II impingement or rotator cuff partial tear and did not have other risk lesions except acromion factor. The mean age was 48.7 years at operation. 21 men(2l shoulders), mean age of 26 years, were used as controls. Acromial type, tilt, and superior displacement of humeral head in sagittal plane, and acromial lateral angulation in coronal plane were measured. Four parameters of the patients were compared with those of control group. And then, the data were subdivided and analyzed with respect to acromial type and patient age in the impingement group. Student t test and multi-way ANOVA were used. Results: In impingement group, Farley's type I acromion, 33%, type Ⅱ, 38%, type Ⅲ, 27% and type Ⅳ, 2%. Superior displacement of humeral head( 4.8mm) were characteristic in the impingement group compared with the control group(1.3mm)(p<0.05). But acromial tilt and lateral angulation were not statistically different. In the analysis of the impingement group, the change of 4 parameters was not significant with respect to age(p>0.05), but lateral angulation in type I acromion(18 degree) and superior displacement of humeral head in type Ⅲ acromion(6.3mm) were significantly increased(p<0.05). All 4 parameters were not different between two subdivided types of type Ⅲ acromion. Conclusion: All types of acromian and large lateral angulatian cauld develop impingement syndrame, but acromial tilt was nat risk factar. Appearance of type Ⅲ acromian and increased superiar displacement of humeral head were characteristic findings in the impingement syndrame. Superiar displacement of humeral head as a result of degenerative change of rotatar cuff was probably primary cause far impingement. The type Ⅲ acromian might be an acquired farm, which cauld be expected to accelerate the tear of rotatar cuff as a cansequence.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2005.03a
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• pp.7-7
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• 2005

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2006.03a
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• pp.2-2
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• 2006

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.75-75
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• 2009