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Subacromial Injection Results in Further Scapular Dyskinesis.

Ettinger L, Shapiro M, Karduna A - Orthop J Sports Med (2014)

Bottom Line: Subacromial injections of anesthetics resulted in increased scapular anterior tilting; however, no changes were noted in upward or internal rotation.When compared with healthy controls, patients had greater anterior tilting and upward rotation of the scapula.The study findings indicate that the removal of pain in patients with impingement results in further dyskinesis of the scapula.

View Article: PubMed Central - PubMed

Affiliation: Department of Exercise Science, Willamette University, Salem, Oregon, USA.

ABSTRACT

Background: Scapular kinematic movement patterns between patients with subacromial impingement and healthy controls have been extensively investigated. However, a high degree of variability has been reported in the literature pertaining to differences between these 2 groups.

Purpose: To investigate the influence of subacromial pain on scapular kinematics.

Study design: Controlled laboratory study.

Methods: A total of 21 patients with stage 2 subacromial impingement who received local anesthetic injections as part of their normal treatment were recruited for this study. The postinjection kinematic data from these patients were compared with those of healthy age-, sex-, and arm dominance-matched controls.

Results: Subacromial injections of anesthetics resulted in increased scapular anterior tilting; however, no changes were noted in upward or internal rotation. When compared with healthy controls, patients had greater anterior tilting and upward rotation of the scapula.

Conclusion: The study findings indicate that the removal of pain in patients with impingement results in further dyskinesis of the scapula.

Clinical relevance: Pain may be causing patients with subacromial impingement to limit scapular tilt and upward rotation, and movement limitations may continue after an anesthetic injection.

No MeSH data available.


Related in: MedlinePlus

(A) Anesthetic subacromial injection with epinephrine and (B) anesthetic injection with corticosteroid.
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fig2-2325967114544104: (A) Anesthetic subacromial injection with epinephrine and (B) anesthetic injection with corticosteroid.

Mentions: Following the scapular kinematic evaluation, patients received 2 subacromial injections of (1) anesthetic (3 mL lidocaine with epinephrine) and (2) corticosteroid (6 mL of 0.5% bupivacaine and 1 mL of 40 mg methylprednisolone acetate) as part of their normal treatment (Figure 2). Patients were then given a 15-minute adjustment period and were asked to move their arm to disperse the drug within the subacromial bursa. Following the adjustment period, patients were asked to repeat their arm elevation task following the same procedure as before. Immediately following the postinjection arm elevation task, patients were again asked to give their current shoulder pain level on an analog pain scale. Patients were blinded from their previous analog pain scale submission. For testing healthy subjects, the same kinematic evaluation was performed; however, no subacromial injections were given to the control group.


Subacromial Injection Results in Further Scapular Dyskinesis.

Ettinger L, Shapiro M, Karduna A - Orthop J Sports Med (2014)

(A) Anesthetic subacromial injection with epinephrine and (B) anesthetic injection with corticosteroid.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4555573&req=5

fig2-2325967114544104: (A) Anesthetic subacromial injection with epinephrine and (B) anesthetic injection with corticosteroid.
Mentions: Following the scapular kinematic evaluation, patients received 2 subacromial injections of (1) anesthetic (3 mL lidocaine with epinephrine) and (2) corticosteroid (6 mL of 0.5% bupivacaine and 1 mL of 40 mg methylprednisolone acetate) as part of their normal treatment (Figure 2). Patients were then given a 15-minute adjustment period and were asked to move their arm to disperse the drug within the subacromial bursa. Following the adjustment period, patients were asked to repeat their arm elevation task following the same procedure as before. Immediately following the postinjection arm elevation task, patients were again asked to give their current shoulder pain level on an analog pain scale. Patients were blinded from their previous analog pain scale submission. For testing healthy subjects, the same kinematic evaluation was performed; however, no subacromial injections were given to the control group.

Bottom Line: Subacromial injections of anesthetics resulted in increased scapular anterior tilting; however, no changes were noted in upward or internal rotation.When compared with healthy controls, patients had greater anterior tilting and upward rotation of the scapula.The study findings indicate that the removal of pain in patients with impingement results in further dyskinesis of the scapula.

View Article: PubMed Central - PubMed

Affiliation: Department of Exercise Science, Willamette University, Salem, Oregon, USA.

ABSTRACT

Background: Scapular kinematic movement patterns between patients with subacromial impingement and healthy controls have been extensively investigated. However, a high degree of variability has been reported in the literature pertaining to differences between these 2 groups.

Purpose: To investigate the influence of subacromial pain on scapular kinematics.

Study design: Controlled laboratory study.

Methods: A total of 21 patients with stage 2 subacromial impingement who received local anesthetic injections as part of their normal treatment were recruited for this study. The postinjection kinematic data from these patients were compared with those of healthy age-, sex-, and arm dominance-matched controls.

Results: Subacromial injections of anesthetics resulted in increased scapular anterior tilting; however, no changes were noted in upward or internal rotation. When compared with healthy controls, patients had greater anterior tilting and upward rotation of the scapula.

Conclusion: The study findings indicate that the removal of pain in patients with impingement results in further dyskinesis of the scapula.

Clinical relevance: Pain may be causing patients with subacromial impingement to limit scapular tilt and upward rotation, and movement limitations may continue after an anesthetic injection.

No MeSH data available.


Related in: MedlinePlus