PHYSICAL THERAPY PROGRAM FOR SHOULDER PAIN SYNDROME

Abstract

Introduction. The aim of the study was to differentiate the nosological forms of shoulder pain syndrome in athletes and to scientifically substantiate and evaluate the clinical effectiveness of a specialized physical therapy program based on instrumental diagnostics compared to conventional rehabilitation protocols.

Materials and Methods. A comprehensive clinical and functional examination was performed on 14 professional athletes (mean age 22.4±1.7 years) presenting with chronic shoulder pain. The diagnostic stage included clinical testing, electroneuromyography (ENMG), and ultrasonography. Participants were randomized into two groups: the control group (CG, n=7), which followed a standard protocol involving therapeutic gymnastics and manual massage, and the main group (MG, n=7), which utilized a differentiated physical therapy program. This program included high-intensity magnetotherapy, targeted muscle electrostimulation, paraffin-ozokerite thermal applications, and mechanotherapy using Artromot devices for passive joint mobilization.

Results. Analysis of the primary diagnostic data revealed that "scapular periarthrosis" often masks specific structural damages. Rotator cuff tendinosis was identified in 50.0% of cases, while tendinosis of the long head of the biceps was found in 14.3%. Compression neuropathies of the suprascapular and axillary nerves accounted for 21.4%, and vertebrogenic radiculopathy (C4-C6 level) was diagnosed in 14.3% of patients. Following the rehabilitation intervention, the MG demonstrated a statistically significant reduction in pain intensity according to the Visual Analog Scale (VAS), decreasing from 6.8±1.9 to 1.5±1.1 points (p=0.005). In contrast, the CG showed only a minor reduction from 6.7±2.1 to 5.3±1.7 points, which did not reach statistical significance. Functional recovery in the MG was characterized by a 24.6% increase in the impulse conduction velocity along motor fibers (p<0.05) according to ENMG data, indicating effective remyelination and restoration of axonal transport. Range of motion (ROM) restoration for abduction reached 172.4±5.2° in the MG compared to 154.8±6.4° in the CG (p<0.05). Total functional reintegration and full ROM were achieved in 94.2% of MG patients, whereas the CG reached only 82.4% (p<0.001). The use of the differentiated program also led to a 1.9-fold decrease in the frequency of syndrome recurrence during the six-month follow-up period.

Conclusions. The study confirms that successful rehabilitation of shoulder pain depends on precise nosological identification. The proposed program of physical therapy shows superior efficiency in pain management and neurological recovery, providing a reliable foundation for the rapid return of athletes to professional training.