Exercises Associated or Not With Manual Therapy Shoulder Impingement

Manual therapy combined with a protocol of therapeutic exercises will increase the beneficial effects on scapular kinematics, myofascial pain and function in subjects with shoulder impingement when compared to exercises only.

Inclusion Criteria:

• history of non-traumatic onset of shoulder pain;
• painful arc during active elevation of the arm;
• one or more positive shoulder impingement tests (Neer, Hawkins and Jobe), or pain during passive or resisted external rotation of the arm at 90° of abduction;
• pain with palpation of the rotator cuff tendons;
• all subjects need also to be able to reach 150° of arm elevation as evaluated by visual observation.

Exclusion Criteria:

• limitation of glenohumeral internal and external rotation as indicative of adhesive capsulitis;
• body mass index > 28kg/m2 as the amount of subcutaneous tissue can compromise the quality of the signal increasing soft tissue artifact;
• numbness or tingling of the upper limb reproduced by cervical compression test;
• history of clavicle, scapula or humerus fracture;
• history of rotator cuff surgery;
• systemic illnesses;
• positive sulcus or apprehension tests as indicative of instability;
• positive drop arm test as indicative of full thickness tear;
• corticosteroid injection within 3 months prior to intervention, or physiotherapy within 6 months prior to intervention;
• depressive symptoms as evaluated by the Beck Depression Inventory score ( > 9 points) due to its influence on myofascial pain;
• allergy to tape.