Eccentric training in chronic painful impingement syndrome of the shoulder: results of a pilot study

Treatment with painful eccentric muscle training has been demonstrated to give good clinical results in patients with chronic Achilles tendinosis. The pain mechanisms in chronic painful shoulder impingement syndrome have not been scientifically clarified, but the histological changes found in the supraspinatus tendon have similarities with the findings in Achilles tendinosis. In this pilot study, nine patients (five females and four males, mean age 54 years) with a long duration of shoulder pain (mean 41 months), diagnosed as having shoulder impingement syndrome and on the waiting list for surgical treatment (mean 13 months), were included. Patients with arthrosis in the acromio-clavicular joint or with large calcifications causing mechanical impingement during horizontal shoulder abduction were not included. We prospectively studied the effects of a specially designed painful eccentric training programme for the supraspintus and deltoideus muscles (3 x 15 reps, 2 times/day, 7 days/week, for 12 weeks). The patients evaluated the amount of shoulder pain during horizontal shoulder activity on a visual analogue scale (VAS), and satisfaction with treatment. Constant score was assessed. After 12 weeks of treatment, five patients were satisfied with treatment, their mean VAS had decreased (62-18, P