Effectiveness of Passive Mobilization in Patients With Subacromial Syndrome

Subacromial syndrome, also known as subacromial impingement, is the most frequent disorder in the shoulder joint. It has a multifactorial origin and represents a wide spectrum of pathologies. Its main consequences are pain and loss of function in the glenohumeral joint. From a biomechanical point of view, subacromial syndrome causes an increment in the anterior and superior translation of the humeral head, which increases compression in the adjacent tissues of the subacromial space, aggravating the symptoms of the patients. Conservative treatments are the first option for subacromial syndrome management, despite the fact that there is limited evidence about its effectiveness, due to the lack of experimental studies.

The aim of this study is to evaluate the effectiveness of a passive joint mobilization (caudal and dorsal gliding) grade II in the glenohumeral joint, within a multimodal approach to reduce pain and improve the range of motion in patients with subacromial syndrome. To this end, a randomized clinical trial will be carried out in the Montpellier Clinic in Zaragoza. Twenty-two patients will be recruited and randomly assigned to one of the two groups (intervention and control). Both groups will receive a standardized treatment consisting of: 10 sessions of infrared rays, and a program of therapeutic exercises and indications to improve their postural hygiene. In addition, the intervention group will receive a passive joint mobilization in the glenohumeral joint of 5 minutes. Pain intensity, range of motion and functionality of the glenohumeral joint will be measured in the first session before any treatment and in the tenth session after the treatment.

Inclusion criteria

• Diagnosis of subacromial syndrome
• Pain at rest, which increases when doing active movements
• Neer´s impingement test positive
• Hawkins Kennedy test positive
• Pain lasting more than one month
• Anteriorization of humeral head
• Full capacity (physical and cognitive) to participate in the study and give consent.

Exclusion criteria

• Infiltrations during the previous six months
• Traumatic origin of pain
• Complete tear of any rotator cuff tendon
• Bilateral pain
• Previous surgical intervention in the affected shoulder
• Patients planning to start with other treatments during the clinical trial.