Association of Shoulder Impingement Syndrome and Latissimus Dorsi Weakness Among Teachers
Article Sidebar
Main Article Content
Abstract
Background: Teachers perform repetitive upper-limb activities that may contribute to shoulder symptoms. The relationship between clinical impingement findings, latissimus dorsi strength, and shoulder-related disability in this occupational group remains insufficiently characterized. Objective: To assess the association of shoulder impingement syndrome and latissimus dorsi weakness among teachers. Methods: This analytical cross-sectional study included 136 teachers from private and government schools in Lahore, Pakistan, selected through convenience sampling. Shoulder pain and disability were assessed using the Shoulder Pain and Disability Index (SPADI); shoulder impingement findings were evaluated with the empty-can and Neer tests; and latissimus dorsi strength was graded by manual muscle testing. Descriptive statistics, correlation analyses, and Kruskal–Wallis tests were applied. Results: Participants included 59 men (43.4%) and 77 women (56.6%); 60 (44.1%) were aged 31–40 years. Mean SPADI pain, disability, and total scores were 29.37%, 21.37%, and 24.64%, respectively. Empty-can and Neer tests were positive in 72 (52.94%) and 52 (38.24%) participants. Latissimus dorsi grade 4 and grade 3 strength were observed in 66 (48.53%) and 64 (47.06%) participants. In teachers with 1–15 years of experience, MMT grade correlated inversely with pain (r = −0.308; p = 0.003), disability (r = −0.387; p < 0.001), and total SPADI score (r = −0.358; p = 0.001). SPADI outcomes also differed across teaching-experience groups (p = 0.010–0.029). Conclusion: Lower latissimus dorsi MMT grades were associated with greater shoulder pain and disability in several subgroups, particularly teachers with 1–15 years of experience; however, the supplied analyses did not establish a direct overall association between impingement-test positivity and muscle weakness.
Article Details
Issue
Section
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
References
1. Michener LA, Walsworth MK, Burnet EN. Effectiveness of rehabilitation for patients with subacromial impingement syndrome: a systematic review. J Hand Ther. 2004;17(2):152–64.
2. McClure PW, Bialker J, Neff N, Williams G, Karduna AR. Shoulder function and three-dimensional kinematics in people with shoulder impingement syndrome before and after a 6-week exercise program. Phys Ther. 2004;84(9):832–48.
3. Urwin M, Symmons D, Allison T, Brammah T, Busby H, Roxby M, et al. Estimating the burden of musculoskeletal disorders in the community: the comparative prevalence of symptoms at different anatomical sites, and the relation to social deprivation. Ann Rheum Dis. 1998;57(11):649–55.
4. Lo YP, Hsu YC, Chan KM. Epidemiology of shoulder impingement in upper arm sports events. Br J Sports Med. 1990;24(3):173–7.
5. Bullock MP, Foster NE, Wright CC. Shoulder impingement: the effect of sitting posture on shoulder pain and range of motion. Man Ther. 2005;10(1):28–37.
6. Miller MD, Thompson SR. Miller’s Review of Orthopaedics. Philadelphia: Elsevier Health Sciences; 2015.
7. Khan Y, Nagy MT, Malal J, Waseem M. The painful shoulder: shoulder impingement syndrome. Open Orthop J. 2013;7(Suppl 3):347–51.
8. Sarkar K, Uhthoff HK. Ultrastructure of the subacromial bursa in painful shoulder syndromes. Virchows Arch A Pathol Anat Histopathol. 1983;400:107–17.
9. Lewis C, Wahlström J, Mukka S, Liv P, Järvholm B, Jackson JA, et al. Surgery for subacromial impingement syndrome and occupational biomechanical risk factors in a 16-year prospective study among male construction workers. Scand J Work Environ Health. 2023;49(2):156.
10. Northover J, Lunn P, Clark D, Phillipson M. Risk factors for the development of rotator cuff disease. Int J Shoulder Surg. 2007;1(3):82.
11. Tate A, Turner GN, Knab SE, Jorgensen C, Strittmatter A, Michener LA. Risk factors associated with shoulder pain and disability across the lifespan of competitive swimmers. J Athl Train. 2012;47(2):149–58.
12. Rahman N, Warikoo D. Association of blackboard teaching with scapular positioning and shoulder pain and disability among school teachers in Dehradun. Int J Pharm Bio Sci. 2013;3(2):475–85.
13. Ramírez-García CO, Lluguay-Quispillo DJ, Inga-Lafebre JD, Cuenca-Lozano MF, Ojeda-Zambrano RM, Cárdenas-Baque CC. Musculoskeletal disorders in primary school teachers. Sustainability. 2023;15(23):16222.
14. Grabara M. The association between physical activity and musculoskeletal disorders—a cross-sectional study of teachers. PeerJ. 2023;11:e14872.
15. Abu Zohair HM, Girish S, Hazari A. Work-related musculoskeletal disorders among United Arab Emirates schoolteachers: an examination of physical activity. BMC Musculoskelet Disord. 2024;25(1):134.
16. Steffenssen MC, Kristiansen AH, Damsgaard TE. A systematic review and meta-analysis of functional shoulder impairment after latissimus dorsi breast reconstruction. Ann Plast Surg. 2019;82(1):116–27.
17. Mitchell B, Imonugo O, Tripp JE. Anatomy, back, extrinsic muscles. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024.
18. Jeno SH, Varacallo M. Anatomy, back, latissimus dorsi. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.
19. Cochran WG. Sampling Techniques. New York: John Wiley & Sons; 1977.
20. Bhatt C, Prajapati B, Patil D, Patel V, Singh BG, Mehta C. Variation in the insertion of the latissimus dorsi and its clinical importance. J Orthop. 2013;10(1):25–8.
21. Spear SL, Hess CL. A review of the biomechanical and functional changes in the shoulder following transfer of the latissimus dorsi muscle. Plast Reconstr Surg. 2005;115(7):2070–3.
22. Akram M, Gillani SF, Farooqi FM, Awais SM. Acromion types and role of corticosteroid with shoulder impingement syndrome. J Coll Physicians Surg Pak. 2016;26:980–3.