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2000 Publications

Quantification of posterior capsule tightness and motion loss in patients with shoulder Tyler TF, Roy T, Nicholas SJ, Gleim GWNIcholas Institute of Sports Medicine and Athletic Trauma, New York, NY. - last modified 2013-02-10 00:00
American Journal of Sports Medicine. 28: 668-673, 2000.


The relationship between posterior capsule tightness and dysfunction has long been recognized clinically but has yet to be biometrically quantified. The purpose of this study was to document changes in ROM and posterior capsule tightness in patients with dominant or non-dominant shoulder impingement.

Measurements of posterior capsule tightness, external rotation range of motion (ROM) and internal rotation ROM were made in 29 patients with shoulder impingement and 33 controls without shoulder pathology. Impingement patients were included if they had full forward flexion passively, a positive Neer impingement sign, no evidence of bone spurs on radiographs and no sign of rotator cuff involvement on physical examination or magnetic resonance imaging.

Patients with impingement in the non-dominant arm had increased posterior capsule tightness and decreased internal rotation and external rotation ROM (P=0.03, P=0.04, P=0.02) as compared to controls. Patients with impingement in their dominant arm had increased posterior capsule tightness and reduced internal rotation ROM but no significant loss of external rotation ROM (P=0.011, P<0.001, P=0.47) as compared to controls.

Posterior capsule tightness measured clinically in impingement patients showed a significant correlation to the loss of internal rotation ROM (r = -0.50, P = 0.006). Patients with shoulder impingement in their non-dominant arm had a more global loss of ROM compared to patients having impingement in their dominant arm. We have described a valid clinical measurement used to identify posterior capsule tightness in patients with shoulder impingement.