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Effects and predictors of shoulder muscle massage for patients with posterior shoulder tightness.

  • Yang et al. BMC Musculoskeletal Disorders 2012

This randomized controlled trial was conducted in a hospital-based outpatient practice (orthopedic and rehabilitation).

Design

43 women and 17 men with posterior shoulder tightness participated and were randomized into massage and control groups (n = 30 per group).

The inclusion criteria were:

  1. limitation of internal rotation ROM compared to the sound side at least 10%;
  2. tightness in the posterior shoulder region. (tightness was defined as more tightness measurement values at least 10% compared to the sound side. Measurement of posterior shoulder tightness was based on horizontal flexion ROM (cross-chest adduction)

Subjects with body mass index (BMI) (less than 19 or more than 24) were expected to have confounding factor of skin/subcutaneous tissue thickness on the muscle tightness.

Exclusion criteria were:

  • surgery on the particular shoulder
  • rheumatoid arthritis
  • stroke with residual shoulder involvement
  • fracture of the shoulder complex.

 A physical therapist (with at least 8 years of clinical experience in manual therapy) provided the massage on the posterior deltoid, infraspinatus, and teres minor of the involved shoulder for 18 minutes [about 6 minutes for each muscle] two times a week for 4 weeks. For the control group, one therapist applied light hand touch on the muscles 10 minutes two times a week for 4 weeks.  The techniques of massage including petrissage for 3 minutes and rolling for 3 minutes of soft tissues.

Results.

For the massage group, the mean glenohumeral inter- nal rotation ROM was 31.9° before massage, and signifi- cantly improved to 54.9° after massage (P < 0.001). Among these patients, 21 were classified as responsive and 8 as nonresponsive. The responsive group had sig- nificantly less duration of symptoms, more mean poster- ior deltoid and infraspinatus slopes (more tightness before massage), and larger FLEX-SF scores (less limited function) than the nonresponsive group

 

Conclusions:

Massage was an effective treatment for patients with posterior shoulder tightness, but was less effective in patients with longer duration of symptoms, higher functional limitation, and less posterior deltoid tightness.