Influence of Kinetic Chain Training on the Treatment Outcome of Overhead Athletes With Impingement

Influence of Kinetic Chain Training on the Treatment Outcome of Overhead Athletes With Shoulder Impingement Syndrome

A randomized controlled trial will be conducted to examine the effectiveness of a traditional home exercise program versus 2 kinetic chain home exercise programs on treatment outcome of overhead athletes with shoulder impingement syndrome. Primary outcome measures are reduction of pain and disability, and improvement in functionality and sports performance. Secondary outcome measures are strength, mobility, flexibility and functional performance.

Participant are randomly assigned in 3 home exercise groups.

1. The traditional program: consists of solely strengthening the rotator cuff muscles and scapular muscles (e.g. external rotation)
2. Separate kinetic chain program: same exercises as the first group but they also receive an exercise program to separately train the core and lower body. (e.g. external rotation separately and squat separately)
3. Integrated kinetic chain program: same exercises as the first group but all exercises are performed while simultaneously activating the kinetic chain. (e.g. external rotation while squatting).

Inclusion Criteria:

• Symptoms of shoulder impingement on the dominant side for at least 3 months and at least 3 of the following tests are considered positive

  • Jobe
  • Hawkins
  • Neer
  • Painful arc during elevation
  • Pain or lack of force production with isometric external rotation
  • Apprehension test
  • Relocation test

• Performing overhead sports at least 3 hours/week

• Shoulder pain interferes with sports activities

• They have not had treatment for this shoulder pain

Exclusion Criteria:

• History of shoulder dislocation or subluxation
• History of orthopedic surgery
• No complaints of pain or dysfunction in the upper limb (except impingement related complaints in the dominant shoulder), lower limb or spine at the last 6 months
• Currently taking nonsteroidal anti-inflammatory medication
• Received a steroid injection in the past 12 months
• Participating in another study
• Known systemic diseases
• Known structural diseases