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JSES Int 2021 May 29;5(3):430-438. Epub 2021 Mar 29.

Department of Orthopedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan.

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. Read More

Dan Med J 2021 May 28;68(6). Epub 2021 May 28.

Introduction: Loss of workdays is the main societal cost related to shoulder disorders with nine lost workdays per six months on average. The most common shoulder disorder is subacromial impingement syndrome (SIS), but it remains unknown if SIS is also a leading cause of shoulder-related loss of worktime. We aimed to investigate the incidence of workdays lost due to SIS during the six months following a SIS diagnosis in specialised care. Read More

Physiotherapy 2020 Oct 13;112:113-120. Epub 2020 Oct 13.

Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Physiotherapy, Linköping University, Sweden.

Objective: The primary aim was to describe the variability within clinical presentation of patients with subacromial pain in primary care, secondly to investigate associations between clinical presentation and self-reported pain intensity, shoulder function, level of anxiety and depression, and health-related quality of life.

Design And Setting: A cross-sectional study based on data from two clinical studies in primary care, one randomized controlled trial and one implementation study. Three components: active range of motion (AROM), rotator cuff function and scapular kinematics were analyzed to describe variability within clinical presentation and patient-reported measurements were used to investigate the impact on daily life. Read More

Appl Bionics Biomech 2021 8;2021:9988857. Epub 2021 May 8.

Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong.

A high proportion of shoulder injuries in table tennis players are common, which is both a diagnostic and therapeutic challenge. An understanding of the interaction between biomechanical function of the shoulder and mechanisms of shoulder injuries in table tennis players is necessary to prevent injury and to conduct clinical treatment of the shoulder as soon as possible. The purpose of this minireview was to select the available evidence on the biomechanical characteristics of shoulder movement and potential relationships with various shoulder injuries that are common in table tennis players. Read More

Physiother Res Int 2021 May 24:e1914. Epub 2021 May 24.

Department of Graduate Studies in Health and Rehabilitation Sciences, Youngstown State University, Youngstown, Ohio, USA.

Objectives: The objectives of this study were the following: (1) to determine if there was a difference in outcomes between immediate responders to glenohumeral mobilizations at the initial evaluation, 2-week, 4-week, and 6-month follow-up as compared to those that do not respond in participants with subacromial pain syndrome; (2) to see if there were statistically significant differences in outcomes within these groups between these time frames of interest, and (3) to see if symptom response at the initial evaluation was predictive of a favorable recovery.

Methods: This was a prospective, single-group observational design. Clinicians pragmatically identified positive responders as improving at least two points on the Numeric Pain Rating Scale and/or a 20° improvement in shoulder active range of motion (AROM) following shoulder mobilization at the initial evaluation. Read More

J Chiropr Med 2021 Mar 12;20(1):9-15. Epub 2021 May 12.

Baskent University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara, Turkey.

Objective: The purpose of this study was to compare the flexibility of the thoracolumbar fascia (TLF) in individuals with and without subacromial impingement syndrome (SAIS). A secondary purpose was to demonstrate a new method for measuring TLF flexibility.

Methods: A total of 60 participants-30 diagnosed with SAIS and 30 asymptomatic-were included. Read More

J Clin Orthop Trauma 2021 Jul 21;18:121-135. Epub 2021 Apr 21.

Wrightington, Wigan and Leigh Teaching Hospital NHS Foundation Trust, Hall Ln, Appley Bridge, Wigan, WN6 9EP, United Kingdom.

The rotator cuff is a group of four muscles and tendons surrounding the shoulder joint providing it strength and stability. The rotator cuff consists of the subscapularis, supraspinatus, infraspinatus and teres minor. Many shoulder complaints are caused by rotator cuff pathology such as impingement syndrome, tendon tears and other diseases e. Read More

J Bodyw Mov Ther 2021 Apr 28;26:94-100. Epub 2020 Dec 28.

Physiotherapy Research Center, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Objective: The aim of this study was to investigate the effects of a combination of dry needling (DN) and muscle energy technique (MET) on pain intensity (PI), pressure pain threshold (PPT) and shoulder active range of motion (ROM) in patients with shoulder impingement syndrome and active trigger points in the infraspinatus muscle.

Methods: 39 patients, aged 20-50 participated in this study. All the cases were randomly assigned into three groups: group 1 (n = 13) received DN, group 2 (n = 13) received MET, and group 3 (n = 13) received DN & MET. Read More

Phys Ther 2021 May 13. Epub 2021 May 13.

Radiology, Rehabilitation and Physiotherapy Department, Universidad Complutense de Madrid, Madrid, Spain.

Objective: The presence of altered nociceptive pain processing in patients with upper extremity tendinopathy/overuse injury is conflicting. Our aim was to compare pressure pain thresholds (PPTs) in symptomatic and distant pain-free areas between patients with upper extremity tendinopathy/overuse injury and controls.

Methods: Five databases were searched from inception to October 15, 2020. Read More

Orthop Surg 2021 May 6. Epub 2021 May 6.

Department of Orthopaedics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.

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. Read More

Arch Phys Med Rehabil 2021 Apr 28. Epub 2021 Apr 28.

Department of Orthopaedic Surgery, Zealand University Hospital, Køge; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

Objective: To study the effects of supervised training in adults with subacromial pain syndrome.

Data Sources: Embase, MEDLINE, Cochrane Library, Cumulative Index to Nursing and Allied Health, and Physiotherapy Evidence Database were searched from inception to March 2020.

Study Selection: Independent reviewers selected randomized controlled trials comparing supervised training with (1) no training or (2) self-training in adults with subacromial pain syndrome lasting for at least 1 month. Read More

J Manipulative Physiol Ther 2021 03 27;44(3):236-243. Epub 2021 Apr 27.

Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. Electronic address:

Objective: This study aimed to determine the intra- and interrater reliability of active and passive range of motion in the shoulders of individuals with subacromial impingement syndrome using a digital inclinometer.

Methods: The raters evaluated active and passive range of motion in the shoulder of 50 individuals with unilateral subacromial impingement syndrome in movements including flexion, abduction, extension, external rotation in a neutral position, external rotation with the arm at 90° of abduction, and internal rotation with the arm at 90° of abduction. The tests were performed by 2 examiners on the same day, with a 10-minute interval, and were repeated by 1 examiner after a 2- to 4-day interval. Read More

Complement Ther Clin Pract 2021 Apr 19;44:101390. Epub 2021 Apr 19.

ENRICH PHYSIO CLINIC, Melbourne, Victoria, Australia.

Purpose: The study aimed to compare the effects of exercise therapy plus manual therapy (ET plus MT) and exercise therapy (ET) alone on muscle activity, muscle onset latency timing and shoulder pain and disability index-Hindi (SPADI-H) score in athletes with shoulder impingement syndrome (SIS).

Materials And Method: Overhead male athletes diagnosed with SIS were randomly allocated into ET plus MT group(n = 40) and ET group(n = 40). Muscle activity, muscle onset latency timings and SPADI-H score were assessed. Read More

Open Access J Sports Med 2021 13;12:43-53. Epub 2021 Apr 13.

USC Epstein Family Center for Sports Medicine at Keck Medicine of USC, Los Angeles, CA, USA.

Athletes participating in overhead sports are at particularly high risk of shoulder impingement syndrome. Subcoracoid impingement is defined as impingement of the anterior soft tissues of the shoulder between the coracoid process and the lesser tuberosity. Subacromial impingement syndrome (SIS) occurs due to extrinsic compression of the rotator cuff between the humeral head and coracoacromial structures or intrinsic degeneration of the supraspinatus tendon and subsequent superior migration of the humerus. Read More

Clin Rehabil 2021 Apr 15:2692155211007799. Epub 2021 Apr 15.

Department of Physical Medicine & Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei.

Objective: To analyse the effectiveness of corticosteroid (CS) and hyaluronic acid (HA) subacromial - subdeltoid (SASD) injection compared with normal saline (NS) in patients with chronic subacromial bursitis (CSB).

Design: A prospective three-arm double-blinded randomised controlled trial.

Setting: Rehabilitation department of two teaching hospitals. Read More

J Wrist Surg 2021 Apr 4;10(2):136-143. Epub 2020 Dec 4.

Beneficência Portuguesa de São Paulo/São Paulo Hand Center, São Paulo, Brazil.

 Distal radius fracture is one of the most common lesions in adults. Surgical techniques have evolved considerably with a clear tendency toward mini-invasive techniques.  Our aim is to push the limits to a 12 mm approach and evaluate its clinical and radiological results. Read More

Medicina (Kaunas) 2021 Mar 1;57(3). Epub 2021 Mar 1.

Laboratory of Musculoskeletal Research, Rambam-Health Care Campus and Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 8 HaAliya HaShniya St., POB 9602, Haifa 3109601, Israel.

Initial evaluation of chronic shoulder disability is a diagnostic challenge due to the anatomic complexity of the shoulder joints. For this purpose, several diagnostic tools utilizing provocative testing exist, but only a few have a reliable basis for their diagnostic value. Therefore, objectively determining the predictive value of these tests in identifying the precise anatomical source for disability-subacromial, intraarticular or other-is essential in order to proceed with further imaging evaluations for final objective diagnoses. Read More

J Orthop Sports Phys Ther 2021 Mar 31:1-45. Epub 2021 Mar 31.

Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, New South Wales, Australia.

Objective: To investigate whether different labels for rotator cuff disease influence people's perceived need for surgery.

Design: Randomized controlled experiment.

Methods: Participants with and without shoulder pain read a vignette describing a patient with rotator cuff disease, and were randomized to one of six labels: and . Read More

J Orthop Surg Res 2021 Mar 9;16(1):180. Epub 2021 Mar 9.

Department of Orthopaedic Trauma, Hong Hui Hospital, Xi'an Jiaotong University School of Medicine, Xi'an, 710054, Shaanxi, China.

Background: Acromioclavicular joint dislocation is a shoulder joint injury common in the clinical setting and is generally surgically treated with clavicular hook plate technique with confirmed curative effect. However, symptoms such as shoulder abduction limitation, shoulder discomfort and joint pain postoperatively may occur in some patients. Therefore, this study aimed to explore whether the existing clavicular hook plate can be reasonably selected to reduce the incidence of subacromial impingement syndrome (SIS) and provide a reference for clinical diagnosis and treatment. Read More

J Physiother 2021 04 17;67(2):124-131. Epub 2021 Mar 17.

Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark.

Question: What are the relative effects of group-based exercise, individual exercise and home-based exercise on clinical outcomes and costs in patients with subacromial pain?

Design: Multicentre, three-arm, randomised controlled trial with concealed allocation and intention-to-treat analysis.

Participants: A total of 208 patients referred to municipal rehabilitation for management of subacromial pain in six municipalities in the Central Denmark Region.

Interventions: Patients were randomly allocated to group-based exercise rehabilitation (GE), individual exercise rehabilitation (IE) or home exercise rehabilitation (HE) for a period of 8 weeks. Read More

J Bodyw Mov Ther 2021 Jan 1;25:35-40. Epub 2020 Nov 1.

Student Research Committee, Department of Physiotherapy, Shiraz University of Medical Sciences, Shiraz, Iran.

Introduction: Infraspinatus is one of the main muscles that is involved in the subacromial impingement syndrome. Dry needling and routine physical therapy can improve this syndrome. However, the dry needling technique is not well defined. Read More

SICOT J 2021 11;7:12. Epub 2021 Mar 11.

Department of Pathology, Mayo University Hospital, Castlebar, Co. Mayo, F23 H529, Ireland.

Subacromial impingement syndrome (SIS) is the leading cause of shoulder pain. A systemic approach for abnormal causes of SIS is recommended to avoid misdiagnosing rare or sinister pathologies. To our knowledge, only nine cases of subacromial lipoma arborescens associated with impingement syndrome have been reported in the literature. Read More

JSES Int 2021 Mar 17;5(2):220-227. Epub 2020 Dec 17.

Department of Orthopedics, Alrijne Hospital, Leiden, the Netherlands.

Background: Varying results after surgery in patients with subacromial pain syndrome (SAPS) have raised the question on whether there is a subgroup of patients that can benefit from surgery. Therefore, we aimed to identify preoperative and peroperative factors associated with a favorable patient-reported outcome after arthroscopic bursectomy in patients with SAPS.

Methods: Patients with chronic SAPS who underwent arthroscopic bursectomy after failed conservative management were included (n = 94). Read More

Integr Med Res 2021 Sep 18;10(3):100693. Epub 2020 Nov 18.

Department of Korean Rehabilitation Medicine, Gwangju Medical Center, College of Korean Medicine, Wonkwang University, Gwangju, Republic of Korea.

Background: Subacromial impingement syndrome (SIS) is one of the most common causes of shoulder pain, and acupuncture treatment is widely used as treatment. However, no studies have examined image-guided acupuncture for SIS. This study evaluated the effectiveness and safety of low-dose X-ray guided acupuncture (LA) in patients with SIS. Read More

BMJ Case Rep 2021 Mar 2;14(3). Epub 2021 Mar 2.

Surgery, West Middlesex University Hospital NHS Trust, Isleworth, UK.

An adult old cyclist presented to our hospital and was referred to the orthopaedic department with a left shoulder posterolateral acromion avulsion fracture and subacromial impingement demonstrated on X-ray and CT. This highly unusual fracture pattern was treated by open reduction and internal fixation with cannulated screws and a tension band suture technique. This fracture went onto successful union with full range of motion and good patient-reported outcome measures by the Oxford Shoulder Score at 3 months. Read More

Clin Shoulder Elb 2021 03 2;24(1):4-8. Epub 2021 Mar 2.

Department of Orthopedic Surgery, Veterans Health Service Medical Center, Seoul, Korea.

Background: As nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids have similar effects, steroids can be avoided to reduce adverse effects. This study aimed to compare the differences in symptom improvement after subacromial injection of steroids or NSAIDs.

Methods: Sixty patients with rotator cuff syndrome for at least 3 months were enrolled and divided into steroid and NSAID groups. Read More

J Rehabil Med 2021 May 11;53(5):jrm00190. Epub 2021 May 11.

Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden. E-mail:

Background: Graded resistance training is the recommended treatment for patients with subacromial pain syndrome. It is debated whether adding joint mobilization will improve the outcome. The aim of this study was to evaluate the clinical outcome of guided exercises with or without joint mobilization, compared with controls who did not receive any treatment. Read More

Phys Ther 2021 May;101(5)

Department of Physical Therapy, Laboratory of Analysis and Intervention of the Shoulder Complex, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil.

Objective: The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire is widely used to assess patients with symptoms of subacromial pain syndrome (SPS). No study has analyzed the DASH by using the Rasch model in these patients and related the level of difficulty of the items with the International Classification of Functioning Disability and Health (ICF) domains. The purpose of this study was to evaluate the measurement properties of the DASH in individuals with SPS and to describe which ICF components are influenced by SPS based on the DASH. Read More

Sci Rep 2021 Feb 18;11(1):4077. Epub 2021 Feb 18.

Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F, 538 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea.

Unnecessary surgery could be prevented through continuity of care (COC). The present study aimed to investigate the relationships between COC, surgery and cost associated with chronic shoulder pain. We used the Health Insurance Review and Assessment Service national patient sample (HIRA-NPS) in 2017. Read More

Indian J Orthop 2021 Feb 11;55(1):195-202. Epub 2020 Jun 11.

Department of Orthopedics and Traumatology, School of Medicine, Kirikkale University, Yurtkur Cad. No:4 Yenisehir, Ankara Yolu 7.Km., Kırıkkale Universitesi Kampusu, 71450 Yahsihan, Kirikkale Turkey.

Purpose: Disturbance of scapulohumeral rhythm has been shown to play a major role in subacromial impingement syndrome. Exercise, taping and subacromial injection are first ray conservative treatment modalities. We aimed to correct scapulohumeral rhythm with kinesio taping and exercise program via focusing on especially periscapular muscles not on glenohumeral structures to achieve scapulothorasic stabilization. Read More