Exercises and reduced need for surgery subacromial pain
Subacromial pain is a common cause of shoulder pain and can be quite painful and disabling. Treatment is challenging, initially using physiotherapy and corticosteroid injections and, when that fails, surgical intervention, usually with arthroscopic subacromial decompression. The authors had previously studied an exercise program that improved symptoms and delayed surgery by at least 3 months and wanted to see if the results lasted 1 year out.
97 patients with subacromial pain but no major rotator cuff (RC) tear, were randomized to specific exercise vs random control exercise groups. All patients were on a waiting list for arthroscopic decompression. The specific exercises included eccentric RC exercises combined with concentric and eccentric exercises for scapula stabilizers with load progression. The control exercises involved 6 active neck and shoulder movements without load progression.
Authors found significantly more patients in control group (63%) decided to have surgery compared to specific exercise group (24%) at 1 year. Patients with partial tears did not differ from those with intact tendons while full thickness tear was predictive of poorer outcomes.
> From: Hallgren et al., Br J Sports Med 48 (2014) 1431-1436. All rights reserved to BMJ Publishing Group Ltd. Click here for the Pubmed summary.