Effect of the scapula reposition test on shoulder impingement symptoms and elevation strength in overhead athletes

STUDY DESIGN: Two-group, repeated-measures design. OBJECTIVES: To determine whether manually repositioning the scapula using the Scapula Reposition Test (SRT) reduces pain and increases shoulder elevation strength in athletes with and without positive signs of shoulder impingement. BACKGROUND: Symptom alteration tests may be useful in determining a subset of those with shoulder pathology who may benefit from interventions aimed at improving scapular motion abnormalities. METHODS AND MEASURES: One hundred forty-two college athletes underwent testing for clinical signs of shoulder impingement. Tests provoking symptoms were repeated with the scapula manually repositioned into greater retraction and posterior tilt. A numeric rating scale was used to measure symptom intensity under both conditions. Isometric shoulder elevation strength was measured using a mounted dynamometer with the scapula in its natural position and with manual repositioning. A paired t test was used to compare the strength between positions. The frequency of a significant increase in strength with scapular repositioning, defined as the minimal detectable change (90% confidence interval), was also assessed. RESULTS: Of the 98 athletes with a positive impingement test, 46 had reduced pain with scapular repositioning. Although repositioning produced an increase in strength in both the impingement (P = .001) and nonimpingement groups (P = .012), a significant increase in strength was found with repositioning in only 26% of athletes with, and 29% of athletes without, positive signs for shoulder impingement. CONCLUSION: The SRT is a simple clinical test that may potentially be useful in an impairment based classification approach to shoulder problems. LEVEL OF EVIDENCE: Diagnosis, Level 4.