![]() Interesting study on internal impingement. However, no baseball players in this study, which make up a good bulk of the internal impingement patients. Purpose: Determine if improvement in GIRD and/or decreased PST after a course of physical therapy are associated with a resolution of symptoms in patients with internal impingement. They hypothesized that symptom resolution would be associated with internal impingement. Methods: Cohort Study. 22 patients (11 men, 11 women). Age 41+/- 13 years. Dx of internal impingement determined by: + relocation test, + posterior impingement sign, posterior GHJ line tenderness, MRI= posterosuperior glenoid labrum lesion Measurements: - Posterior shoulder tightness (PST) - GIRD - ER ROM - Simple shoulder test Intervention: - In the clinic 3x/week for tx - HEP - Manual mobilization and stretching of posterior shoulder - Grade IV posterior glides in scapular plan and max GHJ IR, AAROM cross-chest adduction, sleep stretch, scapular stabilization and strengthening exercises Results: - 12 patients (55%) had COMPLETE resolution of symptoms - 10 patients (45%) had some RESIDUAL symptoms - GIRD, PST and loss of ER ROM all significantly improved after the period of PT - Average improvement in PST was 27 deg - Average improvement in GIRD was 26 deg Key Points: - Prior to treatment, PST was associated with lower Simple shoulder test scores - Improvement in PST was greater in patients who had complete resolution of symptoms vs patients with residual symptoms - Improvements in GIRD and loss of ER ROM were unrelated to outcome Things to consider: - Patients who had complete resolution of symptoms tended to have greater PST before treatment - No baseball players included in study - 5 patients had non-dominant arm involved - Complete resolution of symptoms= 12 on Simple shoulder test Tyler, TF et al. Correction of posterior shoulder tightness is associated with symptom resolution in patients with internal impingement. American Journal of Sports Medicine 2010. 38(1); 114-119
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