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Yang et al. BMC Musculoskeletal Disorders 2012
This randomized controlled trial was conducted in a hospital-based outpatient practice (orthopedic and rehabilitation).
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:
- limitation of internal rotation ROM compared to the sound side at least 10%;
- 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.
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
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.