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Scapular rehab program reduced impingement pain in overhead athletes
Patients who participated in overhead athletics and experienced impingement symptoms showed significant improvement in pain and function after completing an exercise regimen that focused on scapular muscle balance in a recent study.
Researchers conducted a longitudinal study of 47 overhead athletes (mean age, 24.6 years; 53.2% men) who had mild impingement symptoms. Activities included volleyball, swimming and tennis. Patients enrolled in the 6-week home training program performed four previously selected exercises (prone extension, forward flexion in side lying, external rotation in side lying and prone horizontal abduction with external rotation) designed to improve muscle activation and onset timing during shoulder elevation.
The Shoulder Pain and Disability Index (SPADI) measured pain and functionality before and after the program; electromyography was used to record maximum voluntary isometric contraction (MVIC). As patients elevated their arms, researchers also assessed mean muscle activation levels and muscle onset timing for the upper (UT), middle (MT) and lower trapezius (LT) and serratus anterior (SA).
For the 40 patients who completed the program, SPADI scores decreased from 29.86 ± 17.03 at initial assessment to 11.7 ± 13.78 after 6 weeks (P<.001), while MVIC values increased for trapezius muscles (UT, P=.003; MT, P=.026; LT, P=.003) and activation levels decreased during arm elevation. No association was seen in SA (P<.05). Researchers reported UT/SA ratio decreased significantly, but there were no differences in muscle timing before and after the program.
“The results of this study are very promising since limiting shoulder symptoms in active overhead athletes suffering from persistent mild symptoms might serve as a secondary injury prevention measure, limiting continued low-grade shoulder pain, fear avoidance, and ultimately surgical management requirement,” the researchers concluded.