Role of nonoperative treatment of subacromial impingement.

Subacromial impingement syndrome (SIS) occurs when the rotator cuff is compressed by the overlying acromion during shoulder flexion resulting in shoulder pain. The objective of this study was to demonstrate significant relief of symptoms and improved function from physical therapy over long-term follow-up. Eighty-one patients were followed. Patients had subjective and strength assessments at the initial physical therapy visit and 2-year follow-up. Statistical analysis was done using paired t tests for binomial data and Shapiro-Wilk test for the variable data. At 2 years, the Penn shoulder score (81) statistically significantly improved from the initial score (59) for 20 subjects (p = .002). The DASH score improved from 25 to 15 (p = .005). Average external rotation strength deficits compared with the contralateral side improved from 20% to 7% (p = .009). Physical therapy for SIS alleviates symptoms and improves function according to patient-based surveys and strength measurements over a 2-year period.