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Some pathologies can affect individuals who practice physical activity and highintensity exercises, such as those related to bones and joints. In this sense, this article aims to characterize the shoulder impingement syndrome (SIO), identifying its implications, and analyzing training protocols that provide prevention and treatment of this disease. The reasons and reasons that led to the choice of this topic are due to the need to deepen the subject, in view of the lack of studies on, as well as bringing to the debate issues related to the practice of physical activity and some diseases related to it. Specifically, the study aims to identify which are the exercise protocols aimed at preventing this syndrome and analyze their content in terms of their characteristics. The methodological course was based on the types of qualitative and quantitative method approaches. The research was configured as a literature review, produced from the selection of theoretical productions that contained the following keywords in their titles: shoulder and shoulder girdle; shoulder exercises; and shoulder impingement syndrome. Scientific evidence proves that resistance training is effective in preventing and treating OIS, in addition to treating injuries caused by repetitive strain and joint wear. The main conclusions are. [ABSTRACT FROM AUTHOR]

Background: Besides the traditional physical therapy interventions (infrared and strengthening exercises for scapular and shoulder muscles), recently, low-level laser (LLL) and mobilization with movement (MMM) gained more attention in the management of shoulder impingement syndrome (SIS). Aim: To examine the effects of adding LLL to MMM in patients having SIS. Design: A prospective double-blinded randomized trial. Settings: Physical therapy outpatient clinic of Heliopolis University. Participants: Forty patients complaining of unilateral shoulder impingement syndrome for not less than three months and not more than twenty-four months were included. Methods: The patients were randomly assigned to group A (n=20, received the active LLL, MMM, and the abovementioned traditional physical therapy interventions), and group B (n=20, received the same treatments as group A but the LLL was sham). All treatments were applied 3 times per week, for 6 successive weeks. The shoulder pain severity, (assessed via visual analog scale, VAS) and shoulder range of motion (ROM) (flexion, abduction, and internal rotation). Results: The within-group analysis revealed a significant enhancement in all parameters relative to the baseline (P < 0.05). Conclusion: LLL could magnify the gained improvements in pain and ROM when added to MMM and traditional physical therapy interventions in patients with SIS. [ABSTRACT FROM AUTHOR]

Background: Shoulder pain felt when performing daily activities is a common complaint at all ages. Shoulder impingement syndrome is one of the most common causes of shoulder pain. Since this disease is relatively prevalent, there is an urgent need to develop a treatment method with fewer complications. Magnet therapy (MT) is one of the therapies that has been recently used to treat various musculoskeletal disorders. Objectives: This study aimed to evaluate the effects of MT on pain and disability in patients with shoulder impingement syndrome. Methods: In this double-blind clinical trial study, 60 patients diagnosed with shoulder impingement syndrome were randomly assigned to three groups including the "MT 18 Hz" group, the "MT 100 Hz" group, and the "Sham" group. All patients received Magnet therapy three times a week for four weeks in addition to routine treatment. In the sham group, Magnet therapy was used as a placebo. All three groups received routine electrotherapy and exercise therapy. Before and after the treatment, the pain level was evaluated by the NRS scale, the disability level was assessed by the Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH), and the range of motion of the shoulder was measured using a goniometer. The values obtained in the groups and for the groups were compared before and after the treatment. Results: The intragroup comparison of the three groups revealed a statistically significant improvement in all variables (including NRS score, DASH, and shoulder range of motion) (P < 0.05). The intergroup comparison, on the other hand, showed no statistically significant difference for any of the variables (P > 0.05). Conclusions: It was concluded that routine physiotherapy significantly reduced pain and disability as well as improved shoulder range of motions in patients with shoulder impingement syndrome. Moreover, using magnet therapy with two frequencies of 18 and 100 Hz along with the routine electrotherapy and exercise therapy had no additional positive effect on the recovery process of patients with shoulder impingement syndrome. [ABSTRACT FROM AUTHOR]

Introduction: Internal Shoulder impingement is one of the most common problems in athletes with postural asymmetry. The present study aimed to investigate the effect of postural restoration exercises on patients' disabilities and the torque of the shoulder rotator muscles. Materials and Methods: In this clinical trial study, 23 patients with internal shoulder entrapment were randomly divided into control and intervention groups. A positive Ober's test on the left hip indicated pelvic asymmetry and was considered a criterion for admission. Patients in the intervention group were treated with postural restoration exercises for six weeks. The control group did not receive any intervention. Internal and external rotator muscle torque and shoulder functional disability were measured using the Biodex isokinetic and DASH (Disability of Arm, Shoulder, and Hand) questionnaires, respectively. The variables were measured before the intervention, six weeks after the intervention, and four weeks after the completion of the intervention at angular velocities of 60 and 120 o/s at 45o, 70o, and 90o of shoulder abduction. Data analysis was performed using ANOVA with repeated measurements for intergroup comparison. Results: Findings of the present study showed a significant increase (P=0.000) in the isokinetic torque of the shoulder rotator muscles and also a significant decrease in functional disability (P=0.000) in the intervention group compared to the control group Conclusion: The results of this study showed that postural restoration exercises in athletes with pelvic asymmetry can improve functional disability and increase shoulder rotational muscle torque. [ABSTRACT FROM AUTHOR]

Abstract Background Shoulder impingement syndrome (SIS) is the most common form of shoulder pain. Conservative and surgical treatments for SIS are often not effective. One such surgical intervention is subacromial decompression, aimed at widening the subacromial space (SAS). A better understanding of the changes in the SAS may help explain the relative ineffectiveness of current interventions. Objective: To measure the acromiohumeral distance (AHD) and supraspinatus tendon thickness (STT) in people with SIS using a case control study. Methods The AHD and STT of 39 participants with SIS ≥3 months and 39 age, gender and dominant arm matched controls were measured using ultrasound imaging. Between-group differences for AHD and STT were compared using t-tests. A linear regression was used to determine if there was a relationship between AHD and STT measures, with group as a covariate. Results Compared to controls (mean age 55.7 years, SD 10.6), individuals with SIS (mean age 57.1 years, SD 11.1) had a significantly larger AHD (mean difference 2.14 mm, 95% CI 1.21, 3.07, p

Abstract Background Shoulder pain was previously shown to diminish in older populations and it was suggested that this could be explained by reduced usage with age. Our objectives were to investigate if estimates of shoulder pain continue to increase after the age of 50 in working populations and to compare these estimates in physically demanding occupations with sedentary occupations. Methods A systematic review of retrospective, cross-sectional, prospective, or longitudinal. studies reporting prevalence or incidence of non-specific shoulder pain in occupational groups stratified by age. Searches were conducted in PubMed, Scopus, and CINAHL from inception until January 2020. Study characteristics and prevalence estimates stratified by age were extracted. Two reviewers independently performed a critical analysis of the included studies to determine their validity and risk of bias. Results Twenty studies with a total of 40,487 participants and one study of a clinical data base were included and assigned a direction of the estimates for shoulder pain as either ‘increasing’, ‘remaining stable’ or ‘decreasing’ past the age of 50. Shoulder pain generally increased past 50, with 16 of the 21 included studies reporting higher estimates/odds ratios in older participants. In the more physically active occupations over 50, the estimates increased in 14 of the 18 samples compared to only two of the four involving sedentary occupations. Conclusions Shoulder pain prevalence remains common in workers beyond the age of 50. Prevalence continues to increase in physically demanding occupations. Clinicians should consider factors of occupation when managing shoulder pain. Trial registration PROSPERO (CRD42019137831).

Background: Besides the traditional physical therapy interventions (infrared and strengthening exercises for scapular and shoulder muscles), recently, low-level laser (LLL) and mobilization with movement (MMM) gained more attention in the treatment of shoulder impingement syndrome (SIS). Objective: To examine the effects of adding LLL to MMM in patients with SIS. Design: A prospective double-blinded trial. Settings: Physical therapy outpatient clinic of Heliopolis University. Participants: Forty patients complaining of unilateral shoulder impingement syndrome for a period of not less than three months and not more than twenty-four months were included. Methods: The patients were randomly allocated to group A (n=20, received the active LLL, MMM, and the above-mentioned traditional physical therapy interventions), and group B (n=20, received the same treatments as group A but the LLL was sham). All treatments were applied 3 times per week, for 6 successive weeks. Shoulder functionality (assessed via Disabilities of the Arm, Shoulder, and Hand Questionnaire), hand grip strength (assessed with A hand-held dynamometer) and shoulder muscles strength (subscapularis, supraspinatus, and teres minor muscles were assessed using manual muscle testing) were assessed in both groups. Results: The within-group analysis of revealed a significant improvement in all parameters relative to the baseline (P < 0.05). Except for shoulder muscle strength, the between-group analysis indicated a trend of a significant improvement in all tested parameters toward group A (P < 0.05). Conclusion: LLL could magnify the gained improvements in shoulder function and hand grip strength when added to MMM and traditional physical therapy interventions in patients with SIS. [ABSTRACT FROM AUTHOR]

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To investigate whether muscle energy technique (MET) to the thoracic spine decreases the pain and disability associated with shoulder impingement syndrome (SIS). Single-center, 3-arm, randomized controlled trial, single-blind, placebo control with concealed allocation and a 12-month follow-up. Private osteopathic practice. Three groups of 25 participants (N=75) 40 years or older with SIS received allocated intervention once a week for 15 minutes, 4 consecutive weeks. Participants were randomly allocated to MET to the thoracic spine (MET-only), MET plus soft tissue massage (MET+STM), or placebo. Primary outcome measure: Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Secondary outcome measures: Shoulder Pain and Disability Index (SPADI) questionnaire; visual analog scale (VAS) (mm/100): current, 7-day average, and 4-week average; Patient-Specific Functional Scale (PSFS); and Global Rating of Change (GROC). Measures recorded at baseline, discharge, 4-week follow-up, 6 months, and 12 months. Also baseline and discharge thoracic posture and range of motion (ROM) measured using an inclinometer. Statistical analysis included mixed-effects linear regression model for DASH, SPADI, VAS, PSFS, GROC, and thoracic posture and ROM. MET-only group demonstrated significantly greater improvement in pain and disability (DASH, SPADI, VAS 7-day average) than placebo at discharge (mean difference, DASH=−8.4; 95% CI, −14.0 to −2.8; SPADI=−14.7; 95% CI, −23.0 to −6.3; VAS=−15.5; 95% CI, −24.5 to −6.5), 6 months (−11.1; 95% CI, −18.6 to −3.7; −14.9; 95% CI, −26.3 to −3.5; −14.1; 95% CI, −26.0 to −2.2), and 12 months (−13.4; 95% CI, −23.9 to−2.9; −19.0; 95% CI, −32.4 to −5.7; −17.3; 95% CI, −30.9 to −3.8). MET+STM group also demonstrated greater improvement in disability but not pain compared with placebo at discharge (DASH=−8.2; 95% CI, −14.0 to −2.3; SPADI=−13.5; 95% CI, −22.3 to −4.8) and 6 months (−9.0; 95% CI, −16.9 to −1.2; −12.4; 95% CI, −24.3 to −0.5). For the PSFS, MET-only group improved compared with placebo at discharge (1.3; 95% CI, 0.1-2.5) and 12 months (1.8; 95% CI, 0.5-3.2); MET+STM at 12 months (1.7; 95% CI, 0.3-3.0). GROC: MET-only group improved compared with placebo at discharge (1.5; 95% CI, 0.9-2.2) and 4 weeks (1.0; 95% CI, 0.1-1.9); MET+STM at discharge (1.2; 95% CI, 0.5-1.9) and 6 months (1.2; 95% CI, 0.1-1.3). There were no differences between MET-only group and MET+STM, and no between-group differences in thoracic posture or ROM. MET of the thoracic spine with or without STM improved the pain and disability in individuals 40 years or older with SIS and may be recommended as a treatment approach for SIS. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of individualized exercises based on movement fault (MF) control on pain intensity and disability in subjects with chronic subacromial pain syndrome (SAPS)., Design: Randomized Controlled Trial (IRCT20221126056621N1) SETTING: Rehabilitation clinics PARTICIPANTS: Thirty-eight participants with chronic SAPS (aged 52.23(8.47), 60 %woman)., Interventions: The participants were randomly allocated to one of the intervention groups (individualized exercises based on MFs control test designed to target specific movement faults) or the control group (commonly prescribed general scapular stabilization exercises). Both groups received exercise sessions twice a week for four weeks., Main Outcome Measures: The primary outcome measures were pain intensity at rest (PR) and during arm raising (PAR) using a visual analog scale. Disability was assessed as a key secondary outcome, including the disabilities of the arm, shoulder, and hand (DASH) questionnaire and the Shoulder Pain and Disability Index (SPADI)., Results: Following completion of all exercise sessions, PAR was significantly lower in the intervention group compared to the control group (mean [CI]: 9.17 [0.31 to 18.03], p=0.04), with a large effect size [0.68]. The reduction of PAR remained significantly lower in the intervention group than in the control group after four months of follow-up (mean [CI]: 18.29 [9.09 to 27.48], p=0.00) with a large effect size [1.27]. Disability significantly decreased at two month (mean=14.58, p=0.002 on SPADI index; mean=10.26, p=0.006 on DASH index) and four month (mean=19.85, p=0.00 on SPADI index; mean=12.09, p=0.001 on DASH index) follow ups in the intervention group compared to the control group., Conclusion: Individualized exercises based on MFs control of the shoulder region was accompanied by decreased PAR and disability in subjects with SAPS., Competing Interests: Declaration of competing interest There is no Conflict of Interest, (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Exercise therapy (ET) is the main and initial treatment modality for treating subacromial impingement syndrome (SIS). The isolated or combined use of platelet-rich plasma (PRP) applications in treating SIS is increasing and promising. A comparison was made on the effectiveness of ET alone and in combination with PRP on pain, functionality, and quality of life (QoL) in patients with SIS., Purposes/hypothesis: The purposes of this study were to (1) investigate the possible positive effects of PRP injections combined with ET in treating SIS on pain, functionality, and QoL and (2) propose an alternative treatment protocol. It was hypothesized that the group receiving PRP applications in addition to ET would have a better QoL due to less pain and higher functionality 6 months after treatment., Study Design: Randomized controlled trial; Level of evidence, 2., Methods: Volunteer patients diagnosed with SIS were included based on history and physical examination findings. All participants underwent magnetic resonance imaging to confirm the diagnosis and exclude possible accompanying pathologies. The patients were randomly divided into 2 groups. The first group underwent ET at home for 8 weeks (ET group), and the second group received the same ET program and an additional 2 PRP injections, at the beginning of the study and the end of the fourth week (PRP group). Patients were evaluated initially and 6 months after the treatment using the visual analog scale (VAS) for pain score, Constant-Murley Score (CMS), and the 36-Item Short Form Health Survey (SF-36). The Kolmogorov-Smirnov test determined the conformity of the data to a normal distribution, chi-square analysis was used to compare categorical variables between groups, and the Mann-Whitney U test was used to compare continuous and intergroup variables. Intragroup changes before and after treatment were evaluated with the Wilcoxon signed-rank test. P < .05 was considered statistically significant., Results: A total of 67 patients were initially enrolled; 5 were excluded and 6 were lost to follow-up (1 because of a COVID diagnosis). Thus, 56 patients (56 shoulders) were included for analysis. There were 28 patients in the ET group and 28 patients in the PRP group. There were no statistical differences between groups regarding participant characteristics and clinical evaluations before treatment. A statistically significant improvement was observed in pain (VAS subgroups), functionality (CMS subgroups), and QoL (SF-36 subgroups) evaluations of patients in both the ET and the PRP groups compared with before the treatment and 6 months after treatment ( P < .05). At the 6-month posttreatment evaluation, the PRP group was statistically significantly superior to isolated ET in terms of VAS rest ( P = .001) and night ( P = .004) scores. This superiority was also in favor of the PRP group in flexion strength ( P = .001), abduction strength ( P = .046), and abduction degree ( P = .041) measurements. There was no significant difference between ET and PRP groups regarding VAS activity, CMS, and SF-36 scores ( P > .05) at 6 months., Conclusion: Our study showed that both isolated ET and additional PRP application to ET are effective methods in SIS treatment regarding pain, function, and QoL. Combining ET with PRP was superior in reducing pain and improving abduction degree and strength., Competing Interests: The authors declared that they have no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2024.)

Background: Subacromial pain syndrome (SAPS), the most common cause of shoulder pain, can be treated through different treatments with similar effects. Therefore, in terms of deciding on the right treatment fit, patient preferences need to be understood. We aimed to identify treatment characteristics that delineate interventions (attributes) and corresponding sets of specific categorical range (attribute-levels) for SAPS., Methods: This multiple method study systematically reviewed both qualitative and quantitative studies on patient preferences for treatment of SAPS, which informed semi-structured interviews with 9 clinicians and 14 patients. The qualitative data from the interviews was analyzed using the framework analysis formulated by Ritchie and Spencer. Attributes and attribute levels of the systematic review and interviews were summarized and categorized., Results: The search resulted in 2607 studies, 16 of which met the eligibility criteria. The review identified 120 potential attributes, which were synthesized into 25 potential attributes. Fourteen new potential attributes were identified through the interviews, equaling a total of 39 attributes across 11 categories. Levels for 37 attributes were identified through systematic review and interviews, we were unable to identify levels for 2 attributes., Conclusions: This study identified attributes and attribute levels for the treatment of SAPS. There was a discrepancy in the frequency of the represented attributes between the literature and interviews. This study may improve the understanding of patient preferences for the treatment of SAPS and help individualize care. Our study informs a future discrete choice experiment and supports shared decision-making in clinical practice., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Purpose: Kinesio-Taping (KT) is a new therapeutic approach for Shoulder Impingement Syndrome (SIS), which is common in swimmers. This study was performed to investigate the short- and long-term effects of KT on shoulder pain and functional stability in swimmers with SIS. Methods: In this quasi-experimental study (randomized control trial), 28 swimmers with SIS were randomly allocated to the taping and control group. We used the Davis test and Upper Quarter Y-Balance Test (UQYBT) to assess the functional stability of the shoulder girdle and also the Visual Analog Scale (VAS) to assess pain. The data were gathered in three time points: pre-test, 20 minutes, and 72 hours after the procedure. For statistical analysis, we used repeated-measures analyses of variance with a significance level of α

To evaluate the effectiveness of acupuncture treatment for shoulder impingement syndrome (SIS) a literature review was conducted of randomized controlled trials (RCTs) where acupuncture was used as an intervention for patients diagnosed with SIS. Relevant clinical studies (N = 181) were retrieved from several databases based on the inclusion/exclusion criteria, and the interventions and results were analyzed. Six RCTs were selected to review based on the inclusion and exclusion criteria. In all 6 studies, the acupuncture treatment group showed significant positive changes in indicators evaluating pain, disability, and quality of life. A significant decrease in the evaluation indicators (Shoulder Pain and Disability Index, numeric rating scale, Visual Analogue Scale, Constant Murley Shoulder Assessment Score, patient’s global assessment, and doctor’s global assessment) and a significant increase in the questionnaire scores (UCLA, AL-score, EuroQol 5 Dimension Self-Report Questionnaire, and disabilities of the arm, shoulder, and hand) were observed. In addition, 1 study showed similar improvements in pain and quality of life measures in the acupuncture group and corticosteroid injection group. No major side effects were reported. Acupuncture may be an effective and safe treatment for SIS however, further RCTs are required.

Background: Partial-thickness rotator cuff tears are commonly found in the articular-side tendon of the supraspinatus; however, isolated lesions, except those occurring in the supraspinatus tendons, are rare. We report three cases of isolated bursal-side infraspinatus tears that were difficult to detect by magnetic resonance imaging but could be visualized by computed tomography bursography.Case Presentation: Three Asian patients (59-71 years old) with shoulder pain ranging from 1 month to 3 years in duration were each diagnosed with shoulder impingement syndrome. Magnetic resonance imaging studies failed to show a tear of the rotator cuff tendon complex. However, computed tomography bursography showed a longitudinal infraspinatus partial-thickness tear on the bursal side in each case. Arthroscopic decompression of the subacromial space and debridement of the infraspinatus tendon tear successfully alleviated the shoulder pain in two of the three patients; the third patient did not undergo surgery and remained symptomatic at follow-up.Conclusions: In patients with chronic shoulder pain but normal magnetic resonance imaging findings, computed tomography bursography should be considered, as bursal-side infraspinatus tears may be found in these patients. Furthermore, our findings provide a basis for larger studies to further establish the accuracy of computed tomography bursography for these lesions. [ABSTRACT FROM AUTHOR]

Background: Atraumatic full thickness rotator cuff tears (AFTRCT) are common lesions whose incidence increases with age. Physical therapy is an effective conservative treatment in these patients with a reported success rate near 85% within 12 weeks of treatment. The critical shoulder angle (CSA) is a radiographic metric that relates the glenoid inclination with the lateral extension of the acromion in the coronal plane. A larger CSA has been associated with higher incidence of AFTRCT and a higher re-tear rate after surgical treatment. However, no study has yet described an association between a larger CSA and failure of conservatory treatment in ARCT. The main objective of this study is to determine whether there is an association between CSA and failure of physical therapy in patients with AFTRCT.Methods: We reviewed the imaging and clinical records of 48 patients (53 shoulders), 60% female, with a mean age of 63.2 years (95% CI ± 10.4 years); treated for AFTRCT who also underwent a true anteroposterior radiograph of the shoulder within a year of diagnosis of the tear. We recorded demographic (age, sex, type of work), clinical (comorbidities), and imaging data (CSA, size and location of the tear). We divided the patients into two groups according to success or failure of conservative treatment (indication for surgery), so 21 shoulders (39.6%) required surgery and were classified as failure of conservative treatment. Univariate and multivariate analysis was performed to detect predictors of failure of conservative treatment.Results: The median CSA was 35.5º with no differences between those with failure (median 35.5º, range 29º to 48.2º) and success of conservative treatment (median 35.45º, range 30.2º to 40.3º), p = 0.978. The multivariate analysis showed a younger age in patients with failure of conservative treatment (56.14 ± 9.2 vs 67.8 ± 8.4, p < 0.001) and that male gender was also associated with failure of conservative treatment (57% of men required surgery vs 28% of women, p = 0.035).Conclusions: It is still unclear if CSA does predict failure of conservative treatment. A lower age and male gender both could predicted failure of conservative treatment in AFTRCT. Further research is needed to better address this subject. [ABSTRACT FROM AUTHOR]

Background: Shoulder impingement syndrome is the painful entrapment of the soft tissues between the acromion and the humeral head. The severity of shoulder impingement could be graded according to the limitation of shoulder joint moment. The reliability of sonographic findings in the grading of shoulder impingement severity grading is required to be evaluated by the consistency of findings between the observers. Purpose: To assess the interobserver agreement in the sonographic severity grading of shoulder impingement syndrome with the help of a ratio between acromion-to-greater tuberosity distance in the abduction and neutral arm position. Material and methods: Patients were examined by two independent observers in the coronal approach with neutral arm position. Acromion-to-greater tuberosity distance was measured in abduction and neutral shoulder position. The ratios of the distances in the abduction and neutral position were calculated to grade the severity of shoulder impingement syndrome. Results: A total of 78 shoulders were included in this study. A strong agreement was found for the grading of shoulder impingement severity grading between the two independent observers with Kappa value of 0.94. And correlation between the results of the two observers for the severity grading of shoulder impingement syndrome was significant at 0.01 level. Conclusion: Severity grading of the shoulder impingement syndrome was performed based on the ratio of acromion-to-greater tuberosity distance in abduction and neutral arm position. However, the sonographic findings were consistent and a strong interobserver agreement was seen in this sonographic severity grading. [ABSTRACT FROM AUTHOR]

Objective To find out which structure is crucial for the formation of shoulder impingement syndrome with the purpose of directing surgical procedures of subacromial decompression and discussing whether it is necessary to manage acromioclavicular joint during operation and how to do it properly. Methods This was a retrospective study. Clinical data and preoperative computed tomography (CT) images were collected from patients who were diagnosed with rotator cuff tears between January 2017 and August 2019 (sample size: 46) and those who were diagnosed without rotator cuff tears between March 2018 and August 2019 (sample size: 44) in our institution, respectively. Three‐dimensional models of shoulders were established by multiplanar reconstruction of CT scans and measurements were performed on these models. The parameters such as the acromial length and width, the axial tilt, and the distance from acromial margin to glenoid plane were measured in an adjusted axial plane, and the critical shoulder angle and the spatial volume under acromioclavicular joint were measured in an adjusted coronal plane. The demographic characteristics, the acromial morphology and the spatial volume under acromioclavicular joint were compared to find significant differences between the two groups. The association between the axial tilt and the distance from acromial margin to glenoid plane was evaluated by an ordinary least squares linear regression. Results The patients with rotator cuff tears consisted of 16 males and 30 females, among which 30 right shoulders and 16 left shoulders were included. The patients without rotator cuff tears consisted of 28 males and 16 females, among which 15 right shoulders and 29 left shoulders were involved. Significant differences between the groups were found in the acromial width (3.332 cm vs 3.111 cm), the axial tilt (33.765° vs 23.829°), the critical shoulder angle (32.630° vs 30.363°), the distance from anterior 3 cm of lateral acromial margin (range, 2.476 cm–3.302 cm vs 1.993 cm–3.089 cm), and anterior 0.9 cm of medial acromial margin (range, 0.967 cm–2.369 cm vs 0.668 cm–1.993 cm) to glenoid plane, and the spatial volume under acromioclavicular joint (1.089 cm vs 1.446 cm) in the two groups. No significant differences were found in the age (60.0 years vs 58.3 years) or the acromial length (4.187 cm vs 4.184 cm). Significant association was revealed by linear regression analysis between the axial tilt and the distance from anterior two‐thirds of lateral acromial margin to glenoid plane, and similar association was also found in the anterior half of medial margin. Conclusion Anterior two‐thirds of lateral acromial margin, anterior half of medial acromial margin, and inferior aspect of acromioclavicular joint are crucial structures and need to be fully decompressed when treating patients with rotator cuff tears.

Background: Subacromial impingement syndrome is a common disorder associated with functional impairment and disability of the shoulder. Internal/external glenohumeral rotation is important for shoulder function. However, because it is difficult to measure the glenohumeral joint rotation angle physically, the relationship between this angle and the clinical symptoms of subacromial impingement syndrome is still largely unknown. Using advanced cine-magnetic resonance imaging techniques, we designed a study to improve our understanding of the nature of this relationship. Methods: We evaluated 100 shoulders with subacromial impingement syndrome. Patients underwent cine-magnetic resonance imaging during axial rotation with the arm adducted. During imaging, patients rotated their shoulder from maximum internal rotation to maximum external rotation over 10 seconds and then to maximum internal rotation over 10 seconds. The rotation angles were then evaluated using a series of axial images. The Constant–Murley (Constant) and UCLA scores for each patient were determined, and the correlation between the scores and rotational angles was assessed. Patients were divided into 3 groups according to the Constant pain score, and the rotational angles of each group were compared. Rotational angles were also compared between shoulders with and without night pain. Results: The external rotation angle showed a significant but low correlation with the Constant and UCLA scores (ρ = 0.24 and 0.24, respectively), whereas the internal rotation angle did not. In comparing the pain groups of Constant score and UCLA score, the external rotation angle significantly decreased as pain increased (P

Context: Compromise to the acromiohumeral distance (AHD) has been reported in subjects with subacromial impingement syndrome when compared with healthy subjects. In clinical practice, patients are taped with the intention of altering scapular position and influencing the AHD. However, research to determine the effects of taping on AHD is exiguous. Objectives: To evaluate the effect of ridged taping techniques to increase posterior scapular tilt and upward scapular rotation on the AHD. Design: 1-group pretest/posttest repeated-measures design. Setting: Human performance laboratory. Participants: 20 asymptomatic participants (10 male and 10 female) age 27 y (SD 8.0 y). Intervention: Ridged tapping of the scapula into posterior tilt and upward scapular rotation. Main Outcome Measure: Ultrasound measurement of the AHD. Results: AHD increased significantly after rigid tape application to the scapula (P < .003) in healthy shoulders in 60° of passive arm abduction. Conclusion: Taping techniques applied to the scapula had an immediate effect of increasing the AHD in healthy shoulders in 60° of passive arm abduction. Results suggest that taping for increasing posterior scapular tilt and increasing scapular upward rotation can influence the AHD and is a useful adjunct to rehabilitation in patients with subacromial impingement syndrome. [ABSTRACT FROM AUTHOR]

The objective was to evaluate the effectiveness and safety of acupuncture for patients with rotator cuff diseases. There were 12 electronic databases and 3 trial registries searched up to November 30th, 2019. All randomized trials were eligible, regardless of language, date of publication, or settings. The primary outcomes were pain, shoulder function, and proportion of improved participants assessed within 12 weeks of randomization of the trial. The Cochrane risk of bias for the studies was assessed. Effects sizes were presented as a risk ratio, mean difference, or standardized mean difference with a 95% confidence intervals. Grading of Recommendations Assessment, Development and Evaluation approach was adopted to rate certainty of evidence. Of the 3,686 records screened, 28 randomized trials (2,216 participants) were included in this review. The types of acupuncture included manual acupuncture, dry needling, electroacupuncture, acupotomy, warm needle acupuncture, and fire needle acupuncture. All of the studies had an unclear or high risk of bias related to more than 1 domain. Significant benefits of acupuncture in terms of pain and shoulder function were observed in all comparisons, however, the proportion of improved participants was not described in 2 comparisons. There was substantial heterogeneity among meta-analyzed trials. No serious harm was observed. For primary outcomes, the overall certainty of evidence was very low. There was very low certainty of evidence for the benefits of acupuncture for patients with rotator cuff diseases. The safety of acupuncture remains unclear due to the incompleteness of reporting. Future well-designed randomized trials with transparent reporting are required.