Concept: Shoulder problems
Rotator cuff related shoulder pain (RCRSP) is an over-arching term that encompasses a spectrum of shoulder conditions including; subacromial pain (impingement) syndrome, rotator cuff tendinopathy, and symptomatic partial and full thickness rotator cuff tears. For those diagnosed with RCRSP one aim of treatment is to achieve symptom free shoulder movement and function. Findings from published high quality research investigations suggest that a graduated and well-constructed exercise approach confers at least equivalent benefit as that derived from surgery for; subacromial pain (impingement) syndrome, rotator cuff tendinopathy, partial thickness rotator cuff (RC) tears and atraumatic full thickness rotator cuff tears. However considerable deficits in our understanding of RCRSP persist. These include; (i) cause and source of symptoms, (ii) establishing a definitive diagnosis, (iii) establishing the epidemiology of symptomatic RCRSP, (iv) knowing which tissues or systems to target intervention, and (v) which interventions are most effective.
- American journal of physical medicine & rehabilitation / Association of Academic Physiatrists
- Published over 7 years ago
This study aimed to examine the association of hemiplegic shoulder pain (HSP) with central hypersensitivity through pressure-pain thresholds (PPTs) in healthy, distant tissues.
For athletes affected by shoulder problems, the most important expectation is to resume sporting activities. The ability to return to sport is related to several parameters, including the type and level of sport played. By focusing on these parameters, the Degree of Shoulder Involvement in Sports (DOSIS) scale allows for a better assessment of the involvement of the shoulder in sports.
Pain and loss of function are cardinal symptoms associated with Subacromial impingement syndrome (SIS), while the presence and magnitude of deficits in strength and range of motion (ROM) are largely undescribed in non-athletic patients with SIS. Moreover, the relevance of impairments in strength and ROM to patient-reported shoulder function is not well described, even though testing of strength is recommended in clinical guidelines. The purpose of this study was, first, to investigate impairments in glenohumeral and scapulothoracic strength and in abduction and internal rotation ROM in patients with SIS. Secondly, to investigate the influence of these impairments on patient-reported shoulder function.
Chronic shoulder pain is a very complex syndrome, and the mechanisms involved in its perpetuation remain unclear. Psychological factors appear to play a role in the perpetuation of symptoms in people with shoulder chronicity. The purpose of this systematic review is to examine the role of psychological factors in the perpetuation of symptoms (pain intensity and disability) in people with chronic shoulder pain.
Shoulder problems are highly prevalent among elite handball players. Reduced glenohumeral rotation, external rotation weakness and scapula dyskinesis have been identified as risk factors.
Does this patient with shoulder pain have rotator cuff disease?: The Rational Clinical Examination systematic review
- JAMA : the journal of the American Medical Association
- Published over 6 years ago
Rotator cuff disease (RCD) is the most common cause of shoulder pain seen by physicians.
To run a UK based James Lind Alliance Priority Setting Partnership for ‘Surgery for Common Shoulder Problems’.
- The Journal of orthopaedic and sports physical therapy
- Published about 2 years ago
Shoulder pain is a common musculoskeletal complaint that is difficult to treat because of the biomechanical complexity of the shoulder region, the interplay between mobility and stability, and the vital role played by the shoulder in moving, positioning, and providing stability for hand function. Despite advances in biomechanics and pain science, there is still much to learn about how impairments influence shoulder function and health. One impairment, posterior shoulder tightness (PST), is often noted in individuals with shoulder pain and consequently has generated much discussion and debate in recent years. Range-of-motion shifts and deficits are the clinical indicators of PST, with 3 tissue alterations potentially contributing to these modifications: (1) increased humeral retrotorsion (retroversion), (2) reduced posterior glenohumeral joint capsule extensibility, and (3) reduced posterior shoulder muscle/tendon extensibility. The significance of each alteration for shoulder function and the interaction among them remain unclear. It is also unknown if, or to what extent, these impairments can be resolved through interventions. This raises a clinically relevant and straightforward question: when PST is present, should we treat or not treat? In this Viewpoint, we will debate this question and propose that physical therapy interventions have the potential to improve only 1 of the 3 tissue alterations contributing to PST. J Orthop Sports Phys Ther 2018;48(3):133-136. doi:10.2519/jospt.2018.0605.
Peripheral and central sensitization are neurophysiological processes that can prolong painful conditions. Painful shoulder conditions are often persistent, perhaps due to the presence of sensitization.