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Superior-inferior position for all 3 arm positions for each group. Decreasing values represent a more superior position. Error-bars represent standard deviation.
Source publication
Nonrandomized 2 group post-test only.
To compare scapular position and orientation between subjects with and without impingement syndrome.
Abnormal scapular motion is commonly believed to be a contributing factor to shoulder impingement syndrome.
Twenty nonimpaired subjects with a mean age of 34.3 (+/- 7.5 years) and 17 patients with impingement sy...
Contexts in source publication
Context 1
... rotation angle ( ~ i G r e 4) in both the impinge- ment and nonimpaired groups during scapular plane elevation of the arm. In addition, the scapula moved to a more superior position ( Figure 5) and a slightly more medial position ( Figure 6) with increasing arm elevation. ...
Context 2
... differences were found between groups for superior-inferior position at the horizontal and maximum positions of arm elevation. Post hoc test- ing showed that the symptomatic and asymptomatic sides of the impingement group demonstrated signif- icantly greater superior translation at the horizontal and maximum positions of arm elevation compared to nonimpaired comparisons ( Figure 5). The differ- ences between the asymptomatic and symptomatic sides of patients with impingement were not signifi- cant. ...
Citations
... Clinicians have long theorized that scapular movement deviations may predispose a person to these mechanical impingement mechanisms by increasing the magnitude and frequency of compression. 23 For example, persons with shoulder pain have been found to exhibit decreased scapular posterior tilting, 6,20,24 decreased scapular upward rotation, 6,12,20 and increased scapular internal rotation. 40 However, it remains unclear the extent to which altered scapular kinematics influences rotator cuff impingement risk. ...
... Interestingly, however, anterior tilt appears to increase the distance between the coracoacromial ligament and tendon insertions, which is antithetical to previous research and commonly held clinical theory. 19,23,24,26,37 Only the subscapularis tendon followed a pattern where increased anterior tilt reduced the minimum distance. The extent to which changes in scapular impairments impact shoulder symptoms and rotator cuff pathology remains unclear given the lack of longitudinal studies. ...
Background
One proposed mechanism of rotator cuff disease is scapular motion impairments contributing to rotator cuff compression and subsequent degeneration.
Purpose
To model the effects of scapular angular deviations on rotator cuff tendon proximity for subacromial and internal mechanical impingement risk during scapular plane abduction.
Study Design
Descriptive laboratory study.
Methods
Three-dimensional bone models were reconstructed from computed tomography scans obtained from 10 asymptomatic subjects and 9 symptomatic subjects with a clinical presentation of impingement syndrome. Models were rotated to average scapular orientations from a healthy dataset at higher (120°) and lower (subject-specific) humeral elevation angles to investigate internal and subacromial impingement risks, respectively. Incremental deviations in scapular upward/downward rotation, internal/external rotation, and anterior/posterior tilt were imposed on the models to simulate scapular movement impairments. The minimum distance between the rotator cuff insertions and potential impinging structures (eg, glenoid, acromion) was calculated. Two-way mixed-model analyses of variance assessed for effects of scapular deviation and group.
Results
At 120° of humerothoracic elevation, minimum distances from the supraspinatus and infraspinatus insertions to the glenoid increased with ≥5° changes in upward rotation (1.6-9.8 mm, P < .001) or external rotation (0.9-5.0 mm, P≤ .048), or with ≥10° changes in anterior tilt (1.1-3.2 mm, P < .001). At lower angles, ≥20° changes in most scapular orientations significantly increased the distance between the supraspinatus and infraspinatus insertions and the acromion or coracoacromial ligament.
Conclusion
A reduction in scapular upward rotation decreases the distance between the rotator cuff tendon insertions and glenoid at 120° humerothoracic elevation. Interpretation is complicated for lower angles because the humeral elevation angle was defined by the minimum distance.
Clinical Relevance
These results may assist clinical decision making regarding the effects of scapular movement deviations in patients with rotator cuff pathology and scapular dyskinesia and may help inform the selection of clinical interventions.
... Efforts to determine the cause of shoulder pathologies have identified a multifactorial etiology, including anatomical structure, age, overuse, tissue compression, postural deviations, and muscular imbalances [4,5]. While the impact of postural deviations on the development of shoulder pathologies is contentious [6][7][8], available evidence suggests that altered scapular position and forward shoulder posture (FSP) predisposes individuals to shoulder injury [9][10][11][12][13][14]. Thus, correcting FSP may be important for the prevention of shoulder pathologies. ...
... trapezius, rhomboids), greater pectoralis major (PEC) and upper trapezius (UT) muscle excitation, and reduced middle trapezius (MT) excitation [13]. These changes are associated with greater anterior tilt and internal/upward rotation of the scapula [9], thus altering scapulothoracic motion and increasing the risk of shoulder pathology [9][10][11][12][13][14]. ...
... Poor posture typically manifests when the head or shoulders are positioned further forward than the trunk, causing a forward head and chin posture [8,9], forward and downward rotation of the scapulae, an increase in cervical lordosis, and an enhancement in upper TK. These changes can potentially lead to upper quarter pain [10,11,12]. Hence, imbalances in muscle strength and excessive strain on the thoracic spine, due to poor posture, are often the root causes of TK. ...
Background:
In the working environment of modern society, a poor sitting posture for a prolonged time may lead to abnormal spinal alignment such as thoracic kyphosis (TK).
Objective:
This study aimed to evaluate the efficacy of taping for posture correction of patients with TK, providing theoretical and empirical guidance for clinicians attempting to rectify TK posture.
Methods:
The study included 15 subjects aged 30-60 years, all with a TK angle of ⩾ 40∘. Subjects were required to ascend and descend a set of three steps (a low step, high step, and second low step) under three different conditions: without tape assistance, with taping assistance using 20% elongation, and with taping assistance using 40% elongation. A triaxial accelerometer was employed to measure and compare the anterior-posterior (AP), vertical (VT), and medial-lateral (MIL) movements of the thoracic vertebrae in the different conditions.
Results:
There were no significant differences in the MIL (P= 0.903) or AP (P= 0.114) movements between the no tape assistance and 20% elongation taping conditions. However, a significant difference was found in the VT movement (P= 0.017). Comparing the no assistance condition to the 40% elongation taping condition, no significant changes were noted in the MIL movement (P= 0.650), but significant differences were detected in both the VT (P= 0.003) and AP movements (P= 0.016). No significant differences were found in any of the three measurements between 20% and 40% elongation taping.
Conclusion:
Taping serves as an effective method for immediately improving kyphotic posture. It corrects the position of the scapula and cervicothoracic line and exerts passive retraction on the relevant muscles, thus mitigating trunk imbalance.
... compared to non-impaired subjects, impingement patients had a higher superior-inferior scapular position with maximal arm elevation (5.2 cm to 1.6 below the first thoracic vertebrae) (7.5 cm to 1.5).34 A study by Matthew Y.Siow et al. on the association between rotator cuff tears and superior migration of the humeral head and MRIbased anatomic study. ...
Introduction: The third most common musculoskeletal condition is shoulder pain with a prevalence of up to 70%. The second most frequent shoulder condition is subacromial impingement syndrome. Impingement can be classified as either anterosuperior or posterosuperior. Faulty posture, altered scapular or glenohumeral kinematics, posterior capsular tightness, and acromial or coracoacromial arch pathology are all potential extrinsic mechanics that can lead to Subacromial impingement syndrome. The purpose of this review is to find the different variation in translation that takes place in the glenohumeral joint in Subacromial impingement syndrome in overhead workers. Methods: We performed a review of the various translations observed in the glenohumeral joint in subacromial impingement syndrome and discussed the evidence-based studies. For the review, an electronic search for relevant articles using PUBMED, Pedro, Research Gate, and Google Scholar databases up to Dec 2022 was done wherein MeSH search terms and free words were used. Articles underwent the selection process and were selected on the basis of inclusion criteria. Articles were selected based on the author's expertise, self-knowledge and reflective practice. Results: The current study included 11 articles that fulfilled the inclusion criteria suggesting that various humeral translations in overhead workers. The above-reviewed studies provided evidence that based on occupational demands abnormal variations occur. Conclusion: This review has provided an overview of the previous and recent literature on humeral head translation seen in sub-acromial impingement. This study concludes that superior translation is more common as compared to anterior-superior translation and posterior-superior translation.
... Contrary to our expectation, AHD in the supine position was larger than that in the standing position. Several studies have reported that shoulders with subacromial impingement syndrome show decreased scapular posterior tilting compared to healthy shoulders, which may be associated with decreased AHD [31,32]. Considering these findings, the significant posterior tilt of the scapula might contribute to the larger supine AHD. ...
Background
There has been no report comparing shoulder kinematics and muscle activities during axial shoulder rotation in different positions. The purpose of this study was to investigate differences in shoulder kinematics and muscle activities during axial shoulder rotation in healthy subjects between standing and supine positions using three-dimensional/two-dimensional (3D/2D) registration techniques and electromyography (EMG).
Methods
Eleven healthy males agreed to participate in this study. We recorded the fluoroscopy time during active shoulder axial rotation with a 90° elbow flexion in both standing and supine positions, simultaneously recording surface EMG of the infraspinatus, anterior deltoid, posterior deltoid, and biceps brachii. Three-dimensional bone models were created from CT images, and shoulder kinematics were analyzed using 3D/2D registration techniques. Muscle activities were evaluated as a ratio of mean electromyographic values to 5-sec maximum voluntary isometric contractions.
Results
Scapular kinematics during axial shoulder rotation in the supine position showed similar patterns with those in the standing position. The scapula was more posteriorly tilted and more downwardly rotated in the supine posture than in standing (P < 0.001 for both). Acromiohumeral distance (AHD) in the supine posture was significantly larger than in standing. Muscle activities showed no significant differences between postures except for biceps (P < 0.001).
Discussion
Shoulder kinematics and muscle activities during axial rotation were similar in pattern between standing and supine postures, but there were shifts in scapular pose and AHD. The findings of this study suggest that posture may be an important consideration for the prescription of optimal shoulder therapy following surgery or for the treatment of shoulder disorders.
... Previous studies reported decreased muscle activation of SA in shoulder dysfunction and scapular instability. 10,34 In addition, increased muscle activity of the UT was observed to compensate for the weakness of the SA. 10,35 When providing scapular stability, there was no significant difference in the activity of the UT to shoulder flexion during scapular protraction exercise. ...
... Passive stretching causes the greatest amount of passive tension in the shoulder joint capsule, reducing the adhesion in the capsule (Iida et al., 2021). Stretching over the contracted soft tissues in the joint helps improve the chronicity of shoulder tightness (Lukasiewicz et al., 1999). Improvement in the shoulder range is also reported in studies done. ...
... Improvement in the shoulder range is also reported in studies done. They reported that capsular stretching improves shoulder movements (Lukasiewicz et al., 1999;Mertens et al., 2022). ...
Frozen shoulder is a chronic disabling disease of the shoulder. The management of the frozen shoulder are numerous, but the studies show their own limitation. Biomechanically, it was noted that the cause of the frozen shoulder is capsular tightness. However, previous studies are not explained this well. So, this study was designed to identify the effect of capsular stretch on a frozen shoulder. Study was conducted at the OPD of physiotherapy, Chettinad Super Specialist Hospital, Chennai. Two hundred and twenty participants were selected for the study. Screening was conducted for these participants, and eighty were recruited for the study. They were all randomly allocated into two groups, with twenty-five (25) in each. Group I, with 25 subjects,, was given capsular stretching for 15 minutes and moist heat therapy for 10 mins. Group II, with 25 subjects, was given general shoulder exercises for 15 minutes and moist heat therapy for 10 mins. All the subjects were taught with Codman’s pendular exercises as a home programme. Study was conducted for eight (8) weeks. The outcomes selected in this study are pain and range of motion (Abduction & External rotation). This was assessed using a Numerical pain rating scale and Goniometer. Collected data were analyzed using SPSS 24.0. The NPR and ROM variables were examined using the unpaired ‘t’-test with the 0.05%. The result of the study shows that the ‘t’ value for the NPR is 20.25 ± 0.15 with p< 0.05%, the Abduction range of motion is 15.6 ± 2.77, and External rotation is 15.04 ± 1.53. This indicates a marked difference obtained among Group I and Group II, as well as a substantial variation between the pre-intervention and post-intervention values. This study concluded that capsular stretching had significantly improved pain and shoulder range of motion more than shoulder exercises.
... The reliability and specificity of the first reported approach have been questioned by recent LSST research (19) . This conclusion was reinforced by Lukasiewicz et al. (29) , who reported a nonsignificant difference between asymptomatic patients and those with SIS in the medial-lateral scapular position. The scapula's protraction, rotation, and symmetry between the patient group and normal group, as well as between the affected and unaffected sides within the patient group, did not significantly differ, according to Greenfield et al. (24) . ...
... This biceps muscle is a supinator and elbow flexor muscle and, it also acts as a shoulder flexor anatomically [12,14]. Proximal biceps disorder usually results in anterior shoulder pain with radiation into the arm along the muscle belly in some cases [29,30]. However, this study excluded patients with biceps tendinitis. ...
... The shoulder joint is a complex structure with mobility, and static and dynamic stability are provided by the harmonious movement of the rotator cuff muscles, joint capsule, and ligaments 24) . It is related to the abnormal position of the static scapula, scapular dyskinesis which is loss of dynamic control of scapula, impingement syndrome, rotator cuff dysfunction and various shoulder disorders such as instability 25) . Lister et al.'s study 26) , found that the trunk muscle strengthening exercise affects the upper, middle and lower trapezius muscles around the shoulder joint which are related to the movement of upper extremity. ...
[Purpose] The purpose of this study was to investigate the effect of the lumbar stability exercise on the range of motion (ROM) and height difference of the shoulder and to provide basic data to prevent musculoskeletal disorders for improvement of the quality of life of older adults. [Participants and Methods] Twenty older adults without musculoskeletal problems were divided into the lumbar stability exercise group and the passive upper arm exercise group and performed exercise for 30 minutes, 3 times a week for 5 weeks. The shoulder flexion, abduction, extension, and height difference between shoulders were measured. A paired t-test was applied for comparative analysis of data before and after exercise in both groups. [Results] In the lumbar stability exercise group, the shoulder flexion, abduction and height difference were significantly different. In the passive upper arm exercise group, the abduction was significantly different. [Conclusion] Since it was proved that the height difference and range of motion of shoulder are improved when the lumbar stability exercise is indirectly carried out without directly doing shoulder exercise, it is suggested that the lumbar stability exercise is strongly recommended for clinical uses to improve functions in older adults.
