• Title/Summary/Keyword: internal impingement syndrome of the shoulder

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Case Study of shoulder Impingement Syndrome with Subacromial bursitis Improved as Sweet BV herbal acupuncture (Sweet BV 약침을 이용한 견봉하 점액낭염을 동반한 어깨충돌증후군 환자 치험 1례)

  • Lim, Dae-Woong;Lee, Kyung-Jun;Jung, Tae-San;Choi, Byoung-Sun;Choi, Eun-Hee;Lee, Young-Soo
    • Herbal Formula Science
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    • v.18 no.2
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    • pp.259-265
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    • 2010
  • Objectives : The purpose of this study is to report the improvement after Sweet BV herbal acupuncture therapy of shoulder impingement syndrome with Subacromial bursitis. Methods : We treated a patient having shoulder pain due to shoulder impingement syndrome with Sweet BV herbal acupuncture therapy. We checked visual analogue scale (VAS) score and range of movement (ROM). Results : We treated shoulder pain. Thereafter ROM improved and VAS score dropped to the level 3 points from 10 points at onset. Conclusions : This report shows Sweet BV herbal acupuncture therapy has effectiveness on shoulder impingement syndrome with Subacromial bursitis.

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.

Comparison of Effects of Manual Therapy Interventions Combined with Exercise on Range of Motion, Muscle Strength, and Functional Performance in Adolescent Baseball Players with Internal Impingement of Shoulder Joint (어깨관절 내적 충돌증후군을 가진 청소년기 야구선수들의 ROM, 근력, 기능수행정도에 미치는 운동과 도수치료를 혼합한 중재들의 효과 비교)

  • Choo, Yeonki
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.1
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    • pp.101-111
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    • 2020
  • Purpose : The purpose of this study was to identify the comparison of the effects of manual therapy combined with exercise on range of motion (ROM), muscle strength, and functional performance in adolescent baseball players with internal impingement syndrome of the shoulder. Methods : The subjects were 30 patients diagnosed with impingement syndrome of the shoulder. Thirty subjects are randomly assigned to each 3 different groups; Group 1. (exercise group), Group 2. (exercise+mobilization; EMOB group), Group 3. (exercise+mobilization with movement; EMWM group). The interventions were performed three times a week for 4 weeks. The main outcome measures were goniometer, Biodex dynamometer, and Korean Kerlan Jobe shoulder-elbow (K-KJOC) scores. The ROM (external and internal rotation), muscle strength (external and internal rotation: 60 °/sec., 180 °/sec.), and functional performance were compared among the groups. Results : No significant difference was observed among the groups in the range of external rotation of the shoulder before and after the intervention, but the range of internal and total rotation was significantly increased in Group 2, 3 compared to Groups 1. Muscle strength of external and internal rotation (60 °/sec., 180 °/sec.) was not significantly different among Group 1, 2, 3, and functional performance was significantly increased in Group 2, 3 compared to Group 1. However, there was no significant difference between Group 2 and Group 3 in all measurements. Conclusion : An intervention with manual therapy such as EMOB and EMWM was more effective than exercise alone for rapid recovery from shoulder injury and improvement in functional performance. However, further efforts are needed to identify effects of specific interventions with manual therapy.

Case Report of Treatment with Korean Medicine on a Central Post-Stroke Pain Patient who had Impingement Syndrome of the Right Shoulder (우측 어깨의 충격증후군을 동반한 뇌졸중 후 중추성 통증 환자 치험 1례)

  • Lim, Hyun-chan;Kim, Tae-ryun;Lee, Hye-in;Kim, Eun-ji;Lee, Da-eun;Jeon, Sang-yoon
    • The Journal of Internal Korean Medicine
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    • v.38 no.6
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    • pp.1060-1067
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    • 2017
  • Objectives: This case study examined the effects of treatment with traditional Korean medicine on a central post-stroke pain patient, who had impingement syndrome of the right shoulder. Methods: The patient received traditional Korean medical treatments, including acupuncture, warm-needling, moxibustion, and cupping, throughout the treatment period, and extracorporeal shock-wave therapy and physical therapy for part of the treatment period. The effects of treatments were measured with a manual muscle test (MMT), numerical rating scale (NRS), range of motion (ROM), and gait staging index (self-invented). Results: The clinical symptoms of the patient were improved considerably after the complete treatment. Conclusions: Traditional Korean medicine may be effective for treatment of central post-stroke pain in patients with impingement syndrome.

Glenohumeral versus subacromial steroid injections for impingement syndrome with mild stiffness: a randomized controlled trial

  • Yong-Tae Kim;Tae-Yeong Kim;Jun-Beom Lee;Jung-Taek Hwang
    • Clinics in Shoulder and Elbow
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    • v.26 no.4
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    • pp.390-396
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    • 2023
  • Background: The subacromial (SA) space is a commonly used injection site for treatment of impingement syndrome. For shoulder stiffness, glenohumeral (GH) injections are commonly performed. However, in cases of impingement syndrome with mild shoulder stiffness, the optimal site of steroid injection has yet to be identified. Methods: This prospective, randomized study compared the short-term outcomes of ultrasound-guided GH and SA steroid injections in patients who were diagnosed with impingement syndrome and mild stiffness. Each group comprised 24 patients who received either a GH or SA injection of 40 mg of triamcinolone. Range of motion and clinical scores were assessed before and 3, 7, and 13 weeks after the injection. Results: GH and SA injections significantly improved the range of motion and clinical scores after 13 weeks of follow-up. Notably, targeting the GH joint resulted in an earlier gain of forward elevation, external rotation, and internal rotation in 3 weeks (P<0.001, P=0.012, and P=0.002, respectively) and of internal rotation and a Constant-Murley score in 7 weeks (P<0.001 and P=0.046). Subsequent measurements were similar between the groups and showed a steady improvement in all ranges of motion and clinical scores. Conclusions: GH injections may be more favorable than SA injections for treatment of impingement syndrome with mild stiffness, especially in improving the range of motion in the early period. However, the procedures showed similar outcomes after 3 months. Level of evidence: I.

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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Therapeutic Effects of Acupuncture for Shoulder Impingement Syndrome: A Systematic Review and Meta-Analysis (어깨충돌증후군에 대한 침치료의 효과: 체계적 문헌고찰 및 메타분석)

  • Jeong Hoon Ahn;Gun Hee Bae;Byung-Jun Kim;In-Hwa Park;In Heo;Yun-Yeop Cha
    • Journal of Korean Medicine Rehabilitation
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    • v.34 no.1
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    • pp.83-95
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    • 2024
  • Objectives This review was conducted to evaluate the therapeutic effects of manual acupuncture (MA) for shoulder impingement syndrome (SIS). Methods We searched 12 electronic databases (DBpia, Korean studies Information Service System [KISS], Oriental Medicine Advanced Searching Integrated System [OASIS], Research Information Sharing Service [RISS], China National Knowledge Infrastructure [CNKI], CINAHL, Clinical Key, Cochrane Library, Embase, JAMA, PubMed, Web of Science) to find randomized-controlled clinical trials (RCTs) investigating therapeutic effects of MA for treating SIS. Shoulder Pain and Disability Index scores and numeric pain rating scale or visual analogue scale were analyzed as the main evaluation criteria. Results Among 181 studies, 169 were screened and only 12 RCTs were eligible in our review. Finally, 11 RCTs could be statistically analyzed. MA was more effective than sham treatment and physical therapy in terms of reducing pain (p=0.003, p=0.0007 each). Electroacupuncture (EA) showed more significant effect than physical therapy (PT) for improving shoulder pain (p<0.00001) and shoulder functionality (p<0.00001). Conclusions These results suggest that MA and EA could be superior option for treating SIS than sham treatment or PT. However this review has its limitations due to the small sample size and lack of well-designed RCTs that were included in the study. Further well-designed RCTs are necessary to provide high-level evidence.

Effect of Motor Control Training with Strengthening Exercises on Pain and Muscle Strength of Patients with Shoulder Impingement Syndrome

  • Bae, Youn-Hee;Lee, Gyu-Chang
    • The Journal of Korean Physical Therapy
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    • v.23 no.6
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    • pp.1-7
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    • 2011
  • Purpose: The purpose of this study was to investigate the effect of movement training based on motor control theory on pain and average power of muscles in patients with shoulder impingement syndrome and to develop more effective training methods. Methods: We studied 35 patients with shoulder impingement syndrome. Patients were randomly assigned to an experimental group or a control group according to the intervention. The therapeutic modalities such as superficial heat, deep heat, and electronic stimulus, and motor control training with strengthening exercises were applied to the experimental group and therapeutic modalities only were applied to the control group. All interventions were done 3 times a week for 4 weeks. Before the intervention and again after the 4 weeks, we measured pain utilizing a visual analog scale. We measured average power using isokinetic equipment. Results: After application of the intervention, pain significantly decreased in both the experimental group and the control group. There was a significant difference between the extent of the decrease between experimental and control groups. After the intervention, the average power between the two groups were significant at an angle of $60^{\circ}$/sec and $180^{\circ}$/sec for external rotator and internal rotator muscles. They also showed significant improvement in all variables post-intervention compared to pre-intervention. Conclusion: This study indicates that there is an effect in giving appropriate motor control training to patients with shoulder impingement syndrome. It is assumed that there will be a need for more surveys on various variables for motor control training from now on.

Outcome in Impingement Syndrome of the Shoulder According to Presence of Stiffness (견관절 충돌 증후군 환자에서 강직 여부에 따른 치료 결과)

  • Moon, Gi-Hyuk;Lee, Jae-Wook;Yoo, Moon-Jib;Park, Jin-Young
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.1
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    • pp.45-50
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    • 2004
  • Purpose: The purpose of this study is to compare the outcome of operative results in the impingement syndrome of the shoulder with and without the stiffness. Material and Method: Seventy-six patients who had the impingement syndrome without stiffness were evaluated, and treated with the subacromial decompression and 24 patients who had the impingement syndrome with stiffness, were treated with the subacromial decompression and the manipulation. The average follow-up period was 32 months. Result: The impingement syndrome of the shoulder with stiffness was more severe in the preoperative pain and worse in ASES score than without stiffness. The postoperative pain and ASES score improved in the both group. The satisfactory groups were 67% in the group with stiffness and 80% without stiffness. The satisfactory rate was 83% in the group with stiffness and 93% without stiffness. The satisfactory groups with diabetes were 47% in the group with stiffness and 81% without stiffness. Forward elevation, exeternal rotation at the side and internal rotation improved in both groups postoperatively and there were no statistically significant differences postoperatively External rotation was restricted statistically in the group with stiffness. Conclusion: Although patients may not regain the full range of motion, the technique of manipulation followed by arthroscopic subacromial decompression offers good pain relief and satisfactory functional recovery for the impingement syndrome with stiffness. However preoperative counseling is necessary for the impingement syndrome combined with diabetes and stiffness due to poor out come.

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