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The Effects of Cervical and Thoracolumbar Thrust Manipulation on Shoulder Range of Motion in Patients with Rotator Cuff Related Shoulder Pain

Jace Brown, FAAMOPT, PT, DPT, OCS, COMT, Derek Alexander, FAAMOPT, PT, DPT, COMT, Gary Kearns PT, OCS, FAAOMPT, ScD, Steve Karas, PT, OCS, CMPT, DSc

Background and Purpose: Thrust manipulation (TM) to the cervical and thoracic spines have been investigated in Rotator Cuff Related Shoulder Pain (RCRSP), however the effects on clinical range of motion has not been quantified. The purpose of this study was to investigate the immediate and medium-term effects of cervical and thoracolumbar TM on shoulder flexion range of motion (ROM).

Methods: Twenty subjects with RCRSP were recruited via convenience sample and randomly allocated to receive either a C6-C7 or T12-L1 TM. Outcome measures of pain intensity and two shoulder flexion ROM values were assessed before treatment, immediately post-treatment and 2 weeks after treatment.

Results: Statistically significant increase in shoulder ROM with cervical TM (3.75 cm; p<.01) and thoracolumbar TM (7.25 cm; p<.01) were demonstrated immediate post-treatment. No significant differences were noted at two-week follow-up.

Discussion/Conclusion: Cervical and thoracolumbar TM demonstrated within session immediate increased shoulder ROM in RCRSP patients. Potential mechanisms for this change include reduction of muscle tone through alteration of Golgi Tendon Organ and muscle spindle activity via stretch-reflex response or descending pain inhibition. Clinicians may consider cervical or thoracolumbar TM to improve immediate shoulder flexion ROM.