Effects of hand grip exercise on shoulder joint internal rotation and external rotation peak torque

Handgrip Strength Exercises Modulate Shoulder Pain, Function, and Strength of Rotator Cuff Muscles of Patients with Primary Subacromial Impingement Syndrome

Background

Impingement syndrome was shown to be associated with shoulder pain in 44–70% of patients worldwide. It usually occurs due to imbalance and insufficient activation of the rotator cuff (RC) muscles.

Aim

This study explores the relative effects of handgrip-strengthening exercises on shoulder function, pain, strength, and active range of motion as part of the treatment program for the patients with primary subacromial impingement syndrome.

Materials and Methods

A total of 58 patients aged 18-50 years with primary subacromial impingement syndrome were randomly enrolled to participate in this single-blind randomized clinical trial. Out of them, only forty patients have eligibly matched the inclusion criteria and randomly assigned to one of two groups to undergo a standardized therapeutic program consisting of two sessions a week for 8 weeks. The control group prescribed ultrasound therapy, ice, and stretching exercises, while the experimental group followed the same program with the addition of handgrip-strengthening exercises (HGSE). Both patients of conventional therapy (control) and handgrip-strengthening exercises (experimental group) were advised to adhere also to stretching and HGSE exercises once a day at home for eight weeks. The outcomes were the shoulder function, pain intensity, muscle strength, and active range of motion of the shoulder joint.

Results

Patients treated with conventional interventions plus handgrip-strengthening exercises showed the significant improvement over time in shoulder pain and function, strength of rotator cuff muscles, and pain-free range of motion forward flexion, abduction, and external and internal rotation through eight weeks in the experimental group compared to control patient group treated with conventional interventions. In addition, patients of both control and experimental groups showed no significant difference in the adherence to respective home-based stretching and HGSE exercises once a day at home for eight weeks.

Conclusions

Adding handgrip-strengthening exercises to conventional intervention increases the efficacy of treatment for patients with primary subacromial impingement syndrome in terms of shoulder function, pain, muscle strength, and active range of motion.

Detailed management of post-traumatic distal clavicle osteolysis in a 24-year-old female: a case report

INTRODUCTION

Distal clavicular osteolysis (DCO) is a musculoskeletal pathology characterized by shoulder pain. Given the high prevalence of shoulder pain due to rotator cuff and subacromial injuries, DCO is often overlooked. Conservative therapy is indicated prior to surgical intervention. However, no literature has described conservative management of DCO in detail. This report will outline conservative management details for DCO to guide future research and clinicians.

CASE PRESENTATION

A 24-year-old female hockey player presented with trauma-induced injury, where she was diagnosed with type II acromio-clavicular joint separation. She presented 5-months later with residual pain and limitations in ranges of motion (ROM). Radiographic images revealed DCO.

MANAGEMENT AND OUTCOME

Management entailed strict rest from overhead activities followed by rehabilitation and manual therapy. 6-months later the patient reported resolution of symptoms, improved ROMs, and activities of daily living.

SUMMARY

DCO can be difficult to diagnose given its limited etiological understanding, low incidence, and poor radiographic sensitivity. DCO diagnosis should be considered in cases with unresolving shoulder pain.