Is there a link between shoulder pain, shoulder capsule width and rotator cuff (RTC) pathology?

Damien Laruelle, European School of Osteopathy, UK  


Shoulder stability is dependent on active (RTC) and passive (capsule) stabilizers’, pathology of one of them must affect the other. Aside from secondary adhesive caps ulitis there is a paucity of studies investigating the pathogenic relationship between these structures and shoulder pain.  


To investigate whether there is a link between the capsule width, shoulder pain and RTC pathology.      


Observational cross- sectional study  


Participants were recruited from the musculoskeletal ultrasound department of the European School of Osteopathy (ESO) clinic and ESO students, who met the inclusion and exclusion criteria. The outcome measures were, inferior glenohumeral ligament (IGHL) width, Oxford Shoulder Score (OSS) and Shoulder Pain and Disability Index (SPADI). The 13-point RTC scan was used to determine the severity of the pathologies. Data were analysed using Analyse-It; First Normality and variance were tested. Then all the data were analysed to determine whether they could be correlated for significance between the groups. The groups compared were symptomatic shoulder with contralateral control shoulder and a group with RTC tears compared to a group with no RTC tears but RTC pathology.  


A total of 24 participants were recruited, of which seven dropped out through the process and 17 completed the study. Spearman’s test showed a correlation between IGHL versus OSS (rs=-0.43, p=0.01, IGHL versus SPADI (rs=0.37, p=0.03) and OSS versus SPADI (rs=0.97, p<0.0001). Wilcoxon Mann-Whitney test showed statistical significance difference between IGHL in the symptomatic group compared with the control group (p=0.02). However, no statistical difference was found between the group with RTC tear and the group with no RTC tear but RTC pathology (p=0.19).


The results of this study support the idea that there is a possible link between shoulder pain.

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