• 대한족부족관절학회지
• /
• 제15권4호
• /
• pp.195-200
• /
• 2011

Impingement syndrome of the ankle is defined as painful mechanical limitation of full ankle movement secondary to osseous and/or soft tissue abnormality. These conditions occur more commonly in active people and athletes probably because recurrent subclinical injury is an important factor in development of the syndrome. Impingement syndromes of the ankle are categorized according to their anatomical site around the ankle joint. Anterolateral, anterior and posterior impingement has been extensively described in the orthopaedic literature. The purpose of this article is to review the clinical feature and management of anterior impingement syndrome of the ankle.

• The Journal of Korean Physical Therapy
• /
• 제35권6호
• /
• pp.167-176
• /
• 2023

Purpose: Due to the high incidence of shoulder injuries, including shoulder impingement syndrome (SIS), among CrossFit practitioners due to frequent overhead movements, serratus anterior exercises are considered crucial for scapular stabilization in both intervention and prevention. Objective: The objective of this study is to compare the muscle activity and ratios of scapular stabilizing and shoulder girdle muscles between individuals with and without SIS during serratus punch and wall slide exercises, both targeting the serratus anterior muscle, in CrossFit training practitioners. Methods: Surface electromyography was used to compare the muscle activity and activity ratio of scapular stabilizing muscles and shoulder muscles during serratus punch and wall slide exercises in two groups of 20 CrossFit practitioners: ten with SIS and ten without symptoms. Results: The group with SIS showed higher activation of the pectoralis major, upper trapezius, and a higher pectoralis major/serratus anterior and upper trapezius/serratus anterior muscle activation ratio during the serratus punch exercise compared to the group without SIS. Similarly, during the wall slide exercise, the group with SIS exhibited higher activation of the upper trapezius and a higher upper trapezius/serratus anterior muscle activation ratio compared to the group without SIS. However, no significant difference in serratus anterior muscle activation was observed between the two groups. Conclusions: This study highlights the higher activation of the pectoralis major and upper trapezius muscles in CrossFit practitioners with SIS during the serratus anterior exercise, suggesting the importance of minimizing the overactivation of these muscles to prevent impingement syndrome in this population.

• 대한족부족관절학회지
• /
• 제8권1호
• /
• pp.76-80
• /
• 2004

Purpose: We assessed the results of open treatment of anterior impingement syndrome of the ankle in elite level soccer players and concomitant injuries were idenfied. Materials and Methods: We retrospectively reviewed twenty one elite level soccer players diagnosed with anterior impingement syndrome who underwent open debridement between January 1997 and January 2002. All were men and the mean age at the operation was 21 years (range 16 to 27). The mean follow-up duration was 31 months (13 to 71). Concomitant abnormalities were idenfied through physical examination, bone scan and MRI. On a preoperative lateral radiograph, patients were classified according to McDermott's stage. Anteromedial or anterolateral approach was used at the operation and osteophyte was removed with osteotome and rongeur. When chronic ankle instability was accompanying, we performed Modified Brostrom-Gould procedure and for osteochondral lesion, multiple drilling was applied. The Ogilvie-Harris scoring system was used as a clinical scale to evaluate pain, swelling, stiffness and limitation of activity. The results were scored as excellent (15 to 16 points), good (13 to 14) and otherwise unsatisfactory. The time to return to full activity including sports activity was determined. Results: Eighteen of twenty one patients had an excellent outcome. Three patients were graded unsatisfactory and two of them abandoned their career due to the persistence of residual pain. Concomitant abnormalities were found including twelve cases of chronic ankle instability, three cases of osteochondral lesion and two cases of flexor hallucis longus tendinitis. Conclusion: Open debridement was successfully applied to the elite level soccer player with anterior impingement syndrome of the ankle. Considerable coexistence of other abnormalities such as chronic ankle instability may encourage us to consider additional operative procedure.

• 대한관절경학회지
• /
• 제4권1호
• /
• pp.49-53
• /
• 2000

목적 :. 만성 견관절 충돌증후군에 대한 수술적 치료로서 사용한 관절경적 전방 견봉 성형술의 치료 결과를 분석하고 임상적 효용성을 평가하고자 하였다. 대상 및 방법 : 1995년 7월부터 1997년 12월까지 만성 견관절 충돌증후군 환자 중 6개월 이상 보존적 치료에도 불구하고 증상이 호전되지 않아 관절경을 이용하여 전방 견봉 성형술을 시행한 26명의 환자, 27례의 견관절들을 대상으로 하였다. 심한 퇴행성 관절염 회전근 개 전층 파열 및 견관절 비출구 충돌증후군 (nonoutlet impingement) 등은 모두 연구 대상에서 제외하였다. 평균 추시 기간은 2년 3개월(범위, 1년 7개월-3년 11개월)이었다. 임상적인 결과 판정은 UCLA 견관절 평가지수를 이용하였다. 결과 : 27례 중 23례$(85.2\%)$에서 매우 우수 또는 우수한 결과를 보였으며, 4례$(14.8\%)$에서 양호의 결과를 나타내었다. 환자의 만족도는 27례 중 26례$(96.3\%)$에서 주관적인 만족을 나타내었고, 1례 $(3.7\%)$에서 불만족을 나타내었으며 이 경우 Parkinson 증후군과 경추 후종인대 골화증 및 제 5-6번 경추의 척추 협착증이 동반된 환자였다. 결론 : 관절경적 전방 견봉 성형술은 특히 술전 동통의 정도가 술후 현저히 개선되는 등 증상 완화에 우수한 결과를 예상할 수 있는 만성 견관절 충돌증후군의 효율적 치료법이지만, 견관절 및 그 주위의 병변이나 전신 질환 등이 동반될 경우 치료 결과에 영향을 미칠 수 있다.

• 대한임상전기생리학회지
• /
• 제2권1호
• /
• pp.93-100
• /
• 2004

Shoulder impingement syndrome is cause by the collision of acromion, acrominoclaviclar joint, coracoacromino ligament, coracoid process and synovial sac, biceps brachiialis tendon, rotator cuff muscle. Treatment for Shoulder impingement syndrome is genetally classified into two different methods; preservative method and operational method. Operational method includes rotator cuff sutura, anterior acromioplasty, arthroscope decompression. Preservative method includes rest, medicinal therapy, physical therapy. Physical therapy concentrates on pain control, functional recovery and prevention of disease progress. It is also important for physical therapy to maintain the strength of rotator cuff. Strengthening rotator cuff decreases the collision and helps the stability of shoulder joint. In conclusion, it must be aware that shoulder impingement syndrome and some other shoulder problem demand different treatment, which results in a better outcome.

• 대한족부족관절학회지
• /
• 제16권1호
• /
• pp.19-25
• /
• 2012

The ankle impingement syndrome is an established cause of ankle dysfunction. In most cases with suspected ankle impingement, the diagnosis can be possible on the basis of mechanism of injury involved and the clinical examination. An appropriate imaging study should be selected where clinical doubt about the exact diagnosis exists. Radiography plays an important role in the initial assessment of these conditions, especially in anterior and posterior impingement. Magnetic resonance arthrography seems to be the most accurate means of assessing the capsular abnormalities present in anterolateral and anteromedial impingement and for confirmation of possible concomitant injury. Surgical treatment can be considered for the patients who did not respond to conservative treatment for more than 6 months, and has a low complication rate and a high level of success.

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2007년도 제5차 연수강좌
• /
• pp.153-161
• /
• 2007

견관절의 ABER position에서 posterosuperior rotator cuff 가 posterior glenoid에 contact 하여 internal impingement가 일어나는 현상은 운동선수가 아닌 일반인에게도 발생하는 physiologic phenomenon이며 과도한 반복 동작으로 인하여 증상이 발현한다. Internal impingement는 증상이 모호할 뿐만 아니라 견관절 내 여러 병소가 함께 존재하기 때문에 각각의 pathology에 대한 자세하고 정확한 evaluation이 필수적이다. 아직 controversy가 있지만 internal impingement의 pathologic factors로서는 anterior capsular laxity (true anterior laxity), posteroinferior capsular tightness (pseudo anterior laxity)와 이로 인한 glenohumeral internal rotation deficit (GIRD), 그리고 SICK scapula syndrome (scapular dyskinesis) 등으로 요약할 수 있다. 진단은 주로 병력 청취와 신체 검사로 내려지며 ultrasonogram, MRA등으로 확진한다. Sleeper stretching exercise 등과 같은 보존적 치료에 반응이 좋지만 6개월간의 재활 치료에도 호전이 없다면 증상과 직접 관련된 주 병소(appropriate pathology)를 찾아 이에 대한 적절한 수술이 이루어져야 한다.

• PNF and Movement
• /
• 제16권1호
• /
• pp.33-42
• /
• 2018

Purpose: The aim of this study was to investigate the effects of trapezius and serratus anterior strengthening exercise on the shoulder pain and muscle activation of patients with spinal cord injury and functional shoulder impingement syndrome. Methods: The study consisted of 10 patients with spinal cord injury who were hospitalized in Rehabilitation Hospital U, Uijeongbu, South Korea. The exercise was implemented three times a week for 10 weeks. In each session, the subjects performed one of a total of five types of exercise at mid-level intensity. The shoulder pain and disability index (SPADI) was used to evaluate the patients before and after the intervention. The muscle activation of the upper trapezius, middle trapezius, lower trapezius, and anterior serratus muscle was assessed by surface electromyography (EMG) at the beginning of the experiment and 10 weeks later. Wilcoxon's singed-rank test was conducted to determine differences in the pain index and muscle activation before and after the exercise. The level of statistical significance was set at ${\alpha}=0.05$. Results: SPADI scores significantly decreased after the exercise (p<0.05). In comparisons of muscle activation, there was a significant improvement in the upper trapezius at $60^{\circ}$ shoulder joint flexion (p<0.05). There was no significant improvement at $90^{\circ}$ shoulder joint flexion. The middle trapezius showed a significant improvement at $120^{\circ}$ shoulder joint flexion (p<0.05). Conclusion: Trapezius and serratus anterior strengthening exercise reduced pain in spinal cord injury patients with functional shoulder impingement syndrome. The decreased muscle activation of upper trapezius and increased muscle activation of the anterior serratus muscle at $60^{\circ}$ shoulder joint flexion point to positive effects of the exercise on supraduction of the scapula.

• 대한정형외과스포츠의학회:학술대회논문집
• /
• 대한정형외과스포츠의학회 2006년도 제15차 추계학술대회
• /
• pp.41-44
• /
• 2006

• 대한정형외과스포츠의학회:학술대회논문집
• /
• 대한정형외과스포츠의학회 2004년도 The 7th korea-japan joint meeting of orthopaedic sports medicine
• /
• pp.64-64
• /
• 2004