Rotator Cuff Impingement
Pribicevic M, Pollard H. Rotator Cuff Impingement: A case report and literature review. J Manipulative Physiol Ther. 2004;27:9
OBJECTIVE: To describe the symptoms, mechanics, diagnosis and clinical management of shoulder impingement syndrome with a conservative multimodal treatment approach.
CLINCIAL FEATURES: A patient presented with anterior shoulder pain and a diffuse ache in the right upper arm, with tenderness in the shoulder region on palpation. Shoulder range of motion was limited with pain and catching, coupled with limited and painful cervical motion. After physical and orthopaedic examination a clinical diagnosis of shoulder impingement syndrome was made.
INTERVENTIONS AND OUTCOMES: The patient was admitted to a multi-modal treatment protocol including soft tissue therapy ( ischemic pressure and cross-friction massage), 7 minutes of phonophoresis (driving of medication into tissue with ultrasound) with 1% cortisone cream, diversified spinal and peripheral manipulation and rotator cuff and shoulder girdle muscle exercises.
The outcome measures for the study were subjective/objective (VAS) pain measurement, range of motion (goniometer) of the shoulder, and return to normal daily, work and sporting activities. At the end of the treatment protocol the patient was symptom free with all outcome measures being normal. The patient was followed up at 4 and 12 weeks and continued to be symptom free with full range of motion and complete return to normal daily and pre-treatment activities.
CONCLUSION: This case report demonstrates the benefit of a multimodal chiropractic protocol in resolving symptoms associated with shoulder impingement syndrome, and appropriate muscular rehabilitation.
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