Pain inhibition of shoulder strength in patients with impingement syndrome

A. Ben-Yishay, J. D. Zuckerman, M. Gallagher, F. Cuomo

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Fourteen patients with Stage II or III impingement syndrome (average age 58 years) were studied. Nine patients had full-thickness rotator cuff tears documented by arthrograms. Patients initially underwent a thorough shoulder examination followed by baseline isokinetic strength testing. Abduction/adduction testing was performed utilizing a Biodex dynamometer. Maximum concentric contractions were performed, and values for peak torque (PT), total work (W), and power (P) were obtained. All patients received a subacromial injection of 5 cc 1% lidocaine plus 5 cc 0.5% bupivacaine (Marcaine). After 5 minutes the testing sequence was repeated. Clinically, patients demonstrated marked improvement following injection. Eighty-six percent reported complete pain relief; the remaining two patients reported only mild discomfort at the extremes of motion. Improvement in functional activity of the affected shoulder was noted by all subjects. On manual muscle testing, 13 of 14 patients (93%) demonstrated increased abduction strength; 11 of 14 (79%) had improvement in external rotation. Mean increases in active forward elevation and external rotation were 36° and 11°, respectively (P<.01). Postinjection isokinetic changes in PT, W, and P for abduction/adduction were dramatic. For abduction, all patients showed significant increases in P (mean 82%), W (mean 90%), and PT (mean 48%) (all P<.05). No significant differences in range of motion testing or strength parameters were noted based on the presence or absence of a rotator cuff tear. For adduction, all patients showed significant increases in P (mean 208%), W (mean 183%), and PT (mean 41%) (all P<.05). Our findings indicate that pain is an important factor in the etiology of shoulder weakness documented by both clinical examination and isokinetic testing. Isokinetic muscle testing provides a method of quantitating the effect of pain on muscle function as measured by PT, W, and P. This information may be important in assessing the improvement in strength following acromioplasty with or without rotator cuff repair.

Original languageEnglish (US)
Pages (from-to)685-688
Number of pages4
JournalOrthopedics
Volume17
Issue number8
StatePublished - Aug 26 1994
Externally publishedYes

Fingerprint

Shoulder Pain
Torque
Bupivacaine
Inhibition (Psychology)
Pain
Muscles
Injections
Rotator Cuff
Myalgia
Articular Range of Motion
Lidocaine

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Ben-Yishay, A., Zuckerman, J. D., Gallagher, M., & Cuomo, F. (1994). Pain inhibition of shoulder strength in patients with impingement syndrome. Orthopedics, 17(8), 685-688.

Pain inhibition of shoulder strength in patients with impingement syndrome. / Ben-Yishay, A.; Zuckerman, J. D.; Gallagher, M.; Cuomo, F.

In: Orthopedics, Vol. 17, No. 8, 26.08.1994, p. 685-688.

Research output: Contribution to journalArticle

Ben-Yishay, A, Zuckerman, JD, Gallagher, M & Cuomo, F 1994, 'Pain inhibition of shoulder strength in patients with impingement syndrome', Orthopedics, vol. 17, no. 8, pp. 685-688.
Ben-Yishay A, Zuckerman JD, Gallagher M, Cuomo F. Pain inhibition of shoulder strength in patients with impingement syndrome. Orthopedics. 1994 Aug 26;17(8):685-688.
Ben-Yishay, A. ; Zuckerman, J. D. ; Gallagher, M. ; Cuomo, F. / Pain inhibition of shoulder strength in patients with impingement syndrome. In: Orthopedics. 1994 ; Vol. 17, No. 8. pp. 685-688.
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