Effects and predictors of shoulder muscle massage for patients with posterior shoulder tightness

Abstract

Background Clinical approaches like mobilization, stretching, and/or massage may decrease shoulder tightness and improve symptoms in subjects with stiff shoulders. We investigated the effect and predictors of effectiveness of massage in the treatment of patients with posterior shoulder tightness. Methods A randomized controlled trial was conducted in a hospital-based outpatient practice (orthopedic and rehabilitation). Forty-three women and 17 men (mean age = 54 years, range 43-73 years) with posterior shoulder tightness participated and were randomized into massage and control groups (n = 30 per group). A physical therapist provided the massage on the posterior deltoid, infraspinatus, and teres minor of the involved shoulder for 18 minutes [about 6 minutes for each muscle] two times a week for 4 weeks. For the control group, one therapist applied light hand touch on the muscles 10 minutes two times a week for 4 weeks. Glenohumeral internal rotation ROM, functional status, and muscle tightness were the main outcomes. Additionally, the potential factors on the effectiveness of massage were analyzed by multivariate logistic regression. For this analysis, patients with functional score improvement at least 20% after massage were considered responsive, and the others were considered nonresponsive. Results Fifty-two patients completed the study (29 for the massage and 23 for the control). The overall mean internal rotation ROM increased significantly in the massage group compared to the control (54.9° v.s. 34.9°; P ≤ 0.001). There were 21 patients in the responsive group and 8 in the nonresponsive group. Among the factors, duration of symptoms, functional score, and posterior deltoid tightness were significant predictors of effectiveness of massage. Conclusions Massage was an effective treatment for patients with posterior shoulder tightness, but was less effective in patients with longer duration of symptoms, higher functional limitation, and less posterior deltoid tightness. Trial registration This clinical trial is registered at Trial Registration "Trial registration: Clinicaltrials.gov NCT01022827 ".

Systematic Review of Nondrug, Nonsurgical Treatment of Shoulder Conditions

“…There were 77 full-text articles screened (26 SRs and 51 RCTs). Eight were excluded as follows: 1 systematic review was outside the scope of this review (it did not include RCTs of shoulder conditions), 23 leaving 25 SRs; 5 articles designated as RCTs did not actually meet the definition of an RCT (did not test efficacy or did not test between-group differences) [24][25][26][27][28] ; and 2 were outside the scope of our review (1 did not measure patient-based outcomes, 29 and the other was a prognostic study 30 ), leaving 44 RCTs. The research question was clearly defined and the inclusion/exclusion criteria listed in the paper (if "no," then reject).…”

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“…Die Therapie umfasste Weichteiltechniken am M. infraspinatus und M. teres minor [28,38] und manuelle Mobilisationen an der posterioren Gelenkkapsel. Dem Patienten wurde eine Eigendehnung der posterioren Kapsel-und Weichteilstrukturen gezeigt, die er tagsüber mehrfach durchführen sollte.…”

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“…Kim et al [9] obtained evidence from tests that the marjoram, lavender, rosemary and peppermint essential oils 2:1:2:1:1 mixture was effective in reducing pain and depressive symptoms. Massage could also effectively reduce stiffness of shoulder muscles and increased range of motion [10]. Four-hundred people participated on the research of measuring the effects of relaxation and therapeutic massage in chronic back pain.…”