The Effect of Biomechanical Scapular Mobilization With Movement and Motor Learning

The study is about a new technique of mobilization based on normal biomechanics that occurs during the movements of a joint. For example, shoulder abduction or elevation needs the scapula to move upward rotation with posterior tilt and external rotation. Moreover, needs glenohumeral (GH) joint glide inferior and posterior these movements occur normally to permit us to elevate our shoulder without any restriction and the full range of motion(ROM). so in the patients with shoulder problems and have difficulties reaching full ROM of elevation the investigators applied mobilization of scapula toward upward rotation with external rotation and posterior tilt and by using mobilization belt applied posterior and inferior glide to GH joint. However, mobilization techniques have a short-term effect to enhance this effect, the investigators adding a motor learning approach to achieve a long-term effect and prevent recurrent .the investigators applied this technique 3 times per week for 3 weeks.

Inclusion criteria

clinical diagnosis: shoulder impingement syndrome.

• History of shoulder pain when they elevated their arm.
• Limited range of motion due to the pain.
• Pain localized at the painful point at proximal anterolateral shoulder region or medical diagnosis of shoulder impingement syndrome with at least 2 positive impingement tests including Neer, Hawkins, or Jobe test.

Exclusion criteria

• Fibromyalgia.
• Fracture, dislocation, or subluxation of the shoulder.
• history of trauma.
• shoulder surgery.
• numbness or tingling in the upper limb.
• Corticosteroids injection within 1 year.
• systemic illness.
• ligamentous laxity