Effects of Myofascial Chain Tension Modulation Combined With Scapular Corrective Exercise on Scapular Movement Performance and Functional Outcomes in Tennis Players With Subacromial Impingement Syndrome

Participants aged 20 years or older were recruited. Outcome measures included pain intensity, Shoulder Pain and Disability Index (SPADI), shoulder range of motion (flexion, abduction, internal and external rotation), modified Scapular Assistance Test (mSAT), muscle strength (upper, middle, and lower trapezius; serratus anterior; rhomboids; levator scapulae; internal and external rotators), soft tissue elasticity (upper trapezius), myofascial trigger point pain threshold (upper trapezius, pectoralis minor, levator scapulae, rhomboids), subacromial space, and supraspinatus thickness.

Inclusion criteria

• Participants were included if they met all of the following conditions:

• a VAS score greater than 3 during the Hawkins test (indicating mild to moderate pain),
• at least two positive results among the Hawkins test, Neer test, and painful arch test, and
• a positive result on the mSAT. Only participants who fulfilled all three criteria were enrolled in the study.

Exclusion criteria

• Participants were excluded if they had a history of clavicle, scapular, or humeral fractures; shoulder dislocation; or rotator cuff surgery; positive results on the cervical compression test, apprehension test, or drop arm test; had received corticosteroid injections within the past three months; had undergone physical therapy within the past six months; or reported a VAS score higher than 9.