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Quantification of Posterior Capsule Tightness and Motion Loss in Patients with Shoulder Impingement

Timothy F. Tyler, MS, PT, ATC^*,, Stephen J. Nicholas, MD,^*,,, Timothy Roy, PT^|| and Gilbert W. Gleim, PhD^*

^* Nicholas Institute of Sports Medicine and Athletic Trauma at Lenox Hill Hospital, New York
Hofstra University, Hempstead
New York Jets Football Club, New York
^|| Eastside Sports Physical Therapy, New York, New York

Address correspondence and reprint requests to Timothy F. Tyler, MS, PT, ATC, NISMAT at Lenox Hill Hospital, 130 East 77th Street, New York, NY 10021

The relationship between posterior capsule tightness and dysfunction has long been recognized clinically but has not been biometrically quantified. The purpose of this study was to quantify changes in range of motion and posterior capsule tightness in patients with dominant or nondominant shoulder impingement. Measurements of posterior capsule tightness and external and internal rotation range of motion were made in 31 patients with shoulder impingement and in 33 controls without shoulder abnormality. Patients with impingement in the nondominant arm had increased posterior capsule tightness and decreased internal and external rotation range of motion compared with controls. Patients with impingement in their dominant arm had increased posterior capsule tightness and reduced internal rotation range of motion but no significant loss of external rotation range of motion compared with controls. Posterior capsule tightness in impingement patients showed a significant correlation with loss of internal rotation range of motion. Patients with shoulder impingement in their nondominant arm had a more global loss of range of motion compared with patients having impingement in their dominant arm. We believe we have described a valid clinical measurement for identifying posterior capsule tightness in patients with shoulder impingement.

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