Pectoralis Minor Release in Patients With Subacromial Impingement Syndrome

The radiograph will be done to measure acromio-humeral distance, which is considered the shortest distance between the inferior cortex of acromion and the top of humeral head. In normal shoulders, the sub acromial space was between 9 and 10 mm. The space was significantly greater in men, with a slight reduction with age. In middle age, a sub-acromial space less than 6 mm is pathological

Participants will be asked to remain in a relaxed posture with the arms at the side in a neutral position, avoid postural correction, and exhale just before the measurement.

A tape measure was used to measure the linear distance between the origin and insertion of the muscle. The primary investigator of the study performed all measurements. The origin was defined as the inferior aspect of the 4th rib, which was one finger width lateral to the sternum, just lateral to the sternocostal junction. The insertion was defined as the medial-inferior aspect of the coracoid process .

Shoulder flexion, abduction, internal and external rotation movements will be measured with the individual seated upright on a non-reclining high-back chair, to limit trunk compensation. The chair was the same for all movements performed by one individual, but different for each individual, to provide support up to the middle of the scapula.

Shoulder movements will be actively and passively evaluated for flexion in supine and seated positions, abduction, external rotation in a neutral position with 0° abduction (ERN), external rotation with the arm at 90° of abduction (ER90), and internal rotation with the arm at 90° of abduction (IR90) using an Acumar digital inclinometer .

The patients' pain severity will be evaluated using a visual analog scale (VAS). The visual analog scale (VAS) is a validated, subjective measure for acute and chronic pain. Scores are recorded by making a handwritten mark on a 10-cm line that represents a continuum between 0 "no pain" and 10 "worst pain

The disabilities of the arm, shoulder and hand (DASH) questionnaire is a self-administered region-specific outcome instrument developed as a measure of self-rated upper extremity disability and symptoms The use of the DASH questionnaire as an outcomes instrument in patients with upper-extremity complaints. The main part of the Quick-DASH is a 14-item disability/symptom scale concerning the patient's health status during the preceding week. The items ask about the degree of difficulty in performing different physical activities as well as the problem's impact on social activities, work, sleep, and self-image. Each item has five response options. The scores for all items are then used to calculate a scale score ranging from 1 (no difficulty) to 5 ( unable).