Effects of Myofascial Chain Tension Modulation Combined With Scapular Corrective Exercise on Scapular Movement Performance and Functional Outcomes in Tennis Players With Subacromial Impingement Syndrome

Effects of Myofascial Chain Tension Modulation Combined With Scapular Corrective Exercise on Scapular Movement Performance and Functional Outcomes in Tennis Players With Subacromial Impingement Syndrome

Subacromial Impingement Syndrome (SIS) is characterized by abnormal scapular motion, including decreased upward rotation, increased internal rotation, and excessive anterior tilting, which impair shoulder and arm function. Integrated scapular rehabilitation combines Instrument-Assisted Soft Tissue Mobilization (IASTM) and postural correction exercises. IASTM detects soft tissue restrictions through multidirectional strokes and enhances the pain threshold of myofascial trigger points (MTrPs) via reflex hyperemia. Postural correction exercises aim to strengthen weakened muscles and stretch tight ones to improve stability and posture. The combination of these interventions may enhance scapular stability and dynamic control. This study aimed to investigate the effects of integrated scapular rehabilitation on scapular kinematics, movement correction, functional improvement, and pain management in tennis athletes with SIS. A two-way repeated-measures ANOVA was used to analyze pre- and post-intervention effects.

Participants aged 20 years or older were recruited. Outcome measures included pain intensity, Shoulder Pain and Disability Index (SPADI), shoulder range of motion (flexion, abduction, internal and external rotation), modified Scapular Assistance Test (mSAT), muscle strength (upper, middle, and lower trapezius; serratus anterior; rhomboids; levator scapulae; internal and external rotators), soft tissue elasticity (upper trapezius), myofascial trigger point pain threshold (upper trapezius, pectoralis minor, levator scapulae, rhomboids), subacromial space, and supraspinatus thickness.

Inclusion Criteria:

• Participants were included if they met all of the following conditions:

  1. a VAS score greater than 3 during the Hawkins test (indicating mild to moderate pain),
  2. at least two positive results among the Hawkins test, Neer test, and painful arch test, and
  3. a positive result on the mSAT. Only participants who fulfilled all three criteria were enrolled in the study.

Exclusion Criteria:

• Participants were excluded if they had a history of clavicle, scapular, or humeral fractures; shoulder dislocation; or rotator cuff surgery; positive results on the cervical compression test, apprehension test, or drop arm test; had received corticosteroid injections within the past three months; had undergone physical therapy within the past six months; or reported a VAS score higher than 9.