Shoulder problems are very common. In fact 7.5 million physician office visits were attended for shoulder pain in 2006. Among the most common of shoulder disorders is Shoulder Impingement Syndrome (SIS). SIS disorders are currently classified as either primary or secondary. Primary SIS occurs as the result of chronic and repetitive compression or "impingement" of the rotator-cuff tendons in the shoulder, causing pain and movement problems. Secondary SIS is caused by subtle glenohumeral joint instability or hypermobility. The instability combined with inadequate recruitment of rotator cuff and scapula stabilizing muscles, results in excessive anterior and superior migration of the humeral head. The migration of the humerus compresses the soft tissues lying within the subacromial space.
There are several causes to SIS including:
The mainstay of conservative treatment for SIS involves therapeutic exercises to restore normal flexibility and strength to the shoulder girdle. Supervised therapeutic exercise has been proven more superior to home exercise for SIS. Manual therapy combined with supervised therapeutic exercise has proven to be significantly more effective than supervised therapeutic exercise alone.
In 2000 Bang and Deyle compared manual therapy and exercise to exercise only in a group of patients with SIS. The two groups received 7 sessions over 3 weeks and were followed for 1 year. The manual therapy group reported 70% less pain, 35% improvement in function, and 16% increase in isometric shoulder strength. In contrast the exercise only group reported 35% less pain, 17% improvement in function, and no significant improvement in shoulder strength.
So if you want twice the pain relief and improved shoulder strength go see your local PT with orthopaedic specialty credentials and receive an individualized exercise program and manual therapy techniques to address your shoulder problem.
The quadrant is an extremely useful manual therapy technique to assess and mobilize the glenohumeral joint, and associated soft tissue structures. the technique is performed with small oscillatory mobilizations into restricted end ranges, with varying degrees of vigor. By varying the degree of flexion, abduction, and rotation of the humerus, a skilled clinician can pinpoint tight and/or painful structures and produce positive changes in reduced pain and increased mobility.
Bang, M., & Deyle, G. (2000). Comparison of supervised exercise with and without manual physical therapy for patients with shoulder impingement syndrome. Journal of Orthopaedic & Sports Physical Therapy, 30(3), 126-137.
APTA. (2015). Physical therapist's guide to shoulder impingement.
Don Stover PT
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Thanks for visiting my blog page. My name is Don Stover. I am a seasoned physical therapist in Oklahoma City OK. with over 20 years in the biz. I have a lot of knowledge and training in orthopedic PT and spine care. I will be sharing my thoughts on physical therapy for orthopedic problems such as spinal pain, extremity joint pain, sports injuries, health/fitness, and life in general. I hope you enjoy reading!
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