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

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 degrees v.s. 34.9 degrees; 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

Diagnosis and management of adhesive capsulitis

Adhesive capsulitis is a musculoskeletal condition that has a disabling capability. This review discusses the diagnosis and both operative and nonoperative management of this shoulder condition that causes significant morbidity. Issues related to medications, rehabilitation, and post surgical considerations are discussed

Two Micromechanical Models in Acoustoelasticity: a Comparative Study

Herein we derive, under the micromechanical model we proposed earlier, Man and Paroni [14], a complete set of formulae for the twelve material constants in the acoustoelastic constitutive equation for orthorhombic aggregates of cubic crystallites. We present also a second model and compare its predictions on the material constants with those of the first model. Both these models lead to constitutive equations which are indifferent to rotation of reference placement. This allows us to appeal to a new representation theorem (Paroni and Man [15]), which greatly facilitates our derivation of the formulae for the material constants. The second model introduced in this paper is intimately related to some previous averaging theories in the literature. We explain why and in what sense our second model could be taken as a generalization of its predecessors