January 26, 2019
Here are some links to articles about shoulder pain that I hope you will find useful.
If you find links that don’t work, or have any links you wish to share, please use the comment form at the bottom of the page. Thanks.
These links are from my workshop on Assessment and Treatment of Shoulder Pain. Workshops are listed at
High Prevalence of Superior Labral Tears Diagnosed by MRI in Middle-Aged Patients With Asymptomatic Shoulders
Orthop J Sports Med. 2016 Jan 5;4(1):2325967115623212. doi: 10.1177/2325967115623212. eCollection 2016.
The internal rotation less than abduction less than external rotation pattern was demonstrated in 14 of 25 (56%) involved shoulders.
Clin Biomech (Bristol, Avon). 2004 Oct;19(8):810-8.
The Effect of Anterior Versus Posterior Glide Joint Mobilization on External Rotation Range of Motion in Patients With Shoulder Adhesive Capsulitis
“the individuals in the posterior mobilization group had a mean improvement of 31.3°”
J Orthop Sports Phys Ther 2007;37(3):88–99. doi:10.2519/jospt.2007.2307
Working with the sternoclavicular joint to relieve impingement at the acromioclavicular joint.
J Bone Joint Surg Am. 2014 May 21; 96(10): 793–800.
Published online 2014 May 21. doi: 10.2106/JBJS.L.01304
Structure is not Destiny – please don’t rush to freaking out about your x-ray, MRI or ultrasound — Greg Lehman
Subacromial decompression surgery for adults with shoulder pain: a systematic review with meta-analysis | British Journal of Sports Medicine
There was high certainty evidence of no additional benefit of subacromial decompression surgery over placebo surgery in reducing pain at 1 year following surgery
54% of the power comes from the legs and trunk
Kibler, W.B. 1995. Biomechanical analysis of the shoulder during tennis activities.
Clin Sports Med, 14:79-85
24% energy decrease from hip and trunk
requires 34% increase at the shoulder
to deliver the same amount of force
The American journal of sports medicine, 1998 – ajs.sagepub.com
Surgery or Physiotherapy
Exercise in the treatment of rotator cuff impingement: A systematic review and a synthesized evidence-based rehabilitation protocol – Journal of Shoulder and Elbow Surgery
For people diagnosed with atraumatic partial thickness tears of the supraspinatus tendon involving less than 75% of the tendon, a graduated physiotherapy exercise program has been found as beneficial as surgery involving acromioplasty, or acromioplasty and rotator cuff repair.
Kuhn, J. Exercise in the treatment of rotator cuff impingement. A systematic review and synthesized evidence based rehabilitation protocol. 2009, J shoulder Elbow Surg, Jan. – Feb.
International Journal of Yoga Therapy: 2006, Vol. 16, No. 1, pp. 39-47.
Topics in Geriatric Rehabilitation April/June 2011 – Volume 27 – Issue 2 – p 151–161
Tom Ockler, PT
Bahram Jam, MPhty, BScPT, FCAMT
Gentle thawing of the frozen shoulder: A prospective study of supervised neglect versus intensive physical therapy in seventy-seven patients with frozen shoulder syndrome followed up for two years – Journal of Shoulder and Elbow Surgery
Diercks RL, Stevens M., J Shoulder Elbow Surg. 2004 Sep-Oct;13(5):499-502.
Scapula Stability Exercises
Rotator Cuff Pain and Sleepless Nights
Here is a very simple technique to help your shoulder pain clients get a good night’s sleep.
Shoulder Arthroscopy – 1893
Reliability of MRIs
Variability in diagnostic error rates of 10 MRI centers performing lumbar spine MRI examinations on the same patient within a 3-week period
R Herzog, DR Elgort, AE Flanders, PJ Moley – The Spine Journal, 2017 – Elsevier
The Spine Journal, April 2017 Volume 17, Issue 4, Pages 554–561
MRI study of 31 asymptomatic subjects
Age 50+ 72% had rotator cuff disorder
Age 40 – 49 48%
Age 30 -39 43%
Frost, P. Anderson, J.H and Lundorf, E. 1999.
Is supraspinatus pathology as defined by magnetic resonance imaging associated with clinical sign of shoulder impingement? – Journal of Shoulder and Elbow Surgery
87.6% of subjects presented with disc bulging
Spine: 15 March 2015 – Volume 40 – Issue 6 – p 392–398
Ultrasound study on 51 men, aged 40 – 70, asymptomatic for shoulder pain
96% had some degree of moderate to severe shoulder pathology.
Sub acromial bursa thickening 78%
Acromio-clavicular joint degeneration 65%
Supraspinatus tendinosis 39%
Subscapularis tendinosis 25%
Partial thickness tear supraspinatus 22%
Posterior glenoid labral anomaly 14%
Girish, G., Lobo, L.G., Jacobson, J., Morag, Y, Miller, B. and Jamadar, D.
American Journal of Roentgenology, 2011;97, 713-9.
Self Care Exercises