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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

Upward rotation angle during arm elevation preanesthetic (red) and postanesthetic (blue) injection versus healthy controls (green). *Significant difference for between-subject comparisons.
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fig4-2325967114544104: Upward rotation angle during arm elevation preanesthetic (red) and postanesthetic (blue) injection versus healthy controls (green). *Significant difference for between-subject comparisons.

Mentions: For the influence of treatment and humeral elevation on scapular upward rotation, no significant interactions were detected (P = .93). No significant main effect was detected for treatment (P = .17). When comparing postinjection upward rotation to control subjects, a significant interaction between humeral angle and group (controls vs impingement population) was detected (P < .001). Post hoc pairwise comparisons indicate that no significant differences were pronounced between groups at 30° or at 120° (P > .05). However, at 60° of humeral elevation, the impingement group had on average 5.1° ± 1.9° greater upward rotation than controls (P = .013). At 90° of humeral elevation, the impingement group had on average 7.1° ± 1.8° greater upward rotation than controls (P = .001) (Figure 4).


Subacromial Injection Results in Further Scapular Dyskinesis.

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

Upward rotation angle during arm elevation preanesthetic (red) and postanesthetic (blue) injection versus healthy controls (green). *Significant difference for between-subject comparisons.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

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

fig4-2325967114544104: Upward rotation angle during arm elevation preanesthetic (red) and postanesthetic (blue) injection versus healthy controls (green). *Significant difference for between-subject comparisons.
Mentions: For the influence of treatment and humeral elevation on scapular upward rotation, no significant interactions were detected (P = .93). No significant main effect was detected for treatment (P = .17). When comparing postinjection upward rotation to control subjects, a significant interaction between humeral angle and group (controls vs impingement population) was detected (P < .001). Post hoc pairwise comparisons indicate that no significant differences were pronounced between groups at 30° or at 120° (P > .05). However, at 60° of humeral elevation, the impingement group had on average 5.1° ± 1.9° greater upward rotation than controls (P = .013). At 90° of humeral elevation, the impingement group had on average 7.1° ± 1.8° greater upward rotation than controls (P = .001) (Figure 4).

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