Effect of the Scapula Reposition Test on shoulder impingement symptoms and elevation strength in overhead athletes

• Published in: The journal of orthopaedic and sports physical therapy Vol. 38; no. 1; pp. 4 - 11
• Main Authors: Tate, Angela R, McClure, Philip W, Kareha, Stephen, Irwin, Dominic
• Format: Journal Article
• Language: English
• Published: United States 01-01-2008
• Subjects: Adult; Athletic Injuries - diagnosis; Athletic Injuries - physiopathology; Athletic Injuries - prevention & control; Exercise Test; Female; Health Status; Health Status Indicators; Humans; Male; Muscle Contraction; Muscle Strength; Physical Therapy Modalities; Posture; Scapula; Shoulder Impingement Syndrome - diagnosis; Shoulder Impingement Syndrome - physiopathology; Shoulder Impingement Syndrome - prevention & control; Shoulder Pain - physiopathology; Shoulder Pain - prevention & control; Sports Medicine
• ISSN: 0190-6011; 1938-1344
• DOI: 10.2519/jospt.2008.2616

Two group, repeated measures design.
To determine whether manually repositioning the scapula using the Scapula Reposition Test (SRT) reduces pain and increases shoulder elevation strength in athletes with and without positive signs of shoulder impingement.
Symptom alteration tests may be useful in determining a subset of those with shoulder pathology who may benefit from interventions aimed at improving scapular motion abnormalities.
One hundred forty-two college athletes underwent testing for clinical signs of shoulder impingement. Tests provoking symptoms were repeated with the scapula manually repositioned into greater retraction and posterior tilt. A numeric rating scale was used to measure symptom intensity under both conditions. Isometric shoulder elevation strength was measured using a mounted dynamometer with the scapula in its natural position and with manual repositioning. A paired t test was used to compare the strength between positions. The frequency of a significant increase in strength with scapular repositioning, defined as the minimal detectable change (90% confidence interval), was also assessed.
Of the 98 athletes with a positive impingement test, 46 had reduced pain with scapular repositioning. Although repositioning produced an increase in strength in both the impingement (P=.001) and non-impingement groups (P=.012), a significant increase in strength was found with repositioning in only 26% of athletes with, and 29% of athletes without positive signs for shoulder impingement.
The SRT is a simple clinical test that may potentially be useful in an impairment based classification approach to shoulder problems.