Treatment for Subacromial impingement syndrome

Treatment for Subacromial impingement syndrome

Treatment and studies
Studies reveal that both treatments, exercise and arthroscopy, showing a good result in subacromial impingement. Furthermore, it appears that exercise therapy with manual therapy gives better results than just exercise therapy. The results of exercise and arthroscopy are virtually identical. There is no clear difference. It appears that the progress within the first 6 months is also the greatest. After this period, the results remain the same or increase by a non-significant value3,4,5.
Mobility and Stretching exercises for the shoulder
Static stretching is effective at increasing ROM. The greatest change in ROM with a static stretch occurs between 15 and 30 seconds;1,2 most authors suggest that 10 to 30 seconds is sufficient for increasing flexibility.2-5 In addition, no increase in muscle elongation occurs after 2 to 4 repetitions.6
“Sleeper’s stretch exercise for better mobility in the shoulder joint”
Sleepers stretch has been shown to be effective in restoring posterior shoulder tightness.

“Pendelum excerise for shoulder mobility”
By swinging the arm around while leaning forward, the mobility will be increased while not fighting gravitational forces.

“Shoulder mobility exercise with an active assisted range of motion using a gym ball.”
This exercise is meant to increase the range of motion in the shoulder joint using a gym ball or a towel will give an increase in active range of motion while being assisted by the ball or towel.

“External and Internal rotation exercise for mobility and strengthening with a gym ball”

Strengthening the rotator cuff muscles
“External rotation exercise for strengthening the Infraspinatus and Teres minor”
It is important that the elbow is kept at a 90° angle throughout the motion.

“Internal rotation exercise for strengthening the Subscapularis and Teres major”
It is important that the elbow is kept at a 90° angle throughout the motion.

“30° Abduction exercise for supraspinatus”
The supraspinatus is responsible for the first 30° of motion in the shoulder joint.
Literature 1.McHugh MP, Magnusson SP, Gleim GW, Nicholas JA. Viscoelastic stress relaxation in human skeletal muscle. Med Sci Sports Exerc. Dec 1992;24(12):1375-1382.

2.Bandy WD, Irion JM. The effect of time on static stretch on the flexibility of the hamstring muscles. Phys Ther. Sep 1994;74(9):845–850; discussion 850-842.

3.Bandy WD, Irion JM, Briggler M. The effect of time and frequency of static stretching on flexibility of the hamstring muscles. Phys Ther. Oct 1997;77(10):1090-1096.

4.Ayala F, de Baranda Andujar PS. Effect of 3 different active stretch durations on hip flexion range of motion. J Strength Cond Res. Feb 2010;24(2):430-436.

5.Cipriani D, Abel B, Pirrwitz D. A comparison of two stretching protocols on hip range of motion: implications for total daily stretch duration. J Strength Cond Res. May 2003;17(2):274-278.

6.Taylor DC, Dalton JD, Jr., Seaber AV, Garrett WE., Jr. Viscoelastic properties of muscle-tendon units. The biomechanical effects of stretching. Am J Sports Med. May-Jun 1990;18(3):300-309.

 

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