Sore Shoulder in Physical Practice

Sore shoulder or shoulder region is frequently encountered in general population. According to reference data prevalence ranges between 15 and 20% in 40-45 age group. A weak bone support enables extensive excursions of this joint and simultaneously reduces its stability. We analyzed successfulness of sore shoulder treatment in a sample of 1115 patients treated in the Center for physical medicine and rehabilitation between 1996 and 2004. All the patients reported to the Center either in acute phase or in the phase of chronic state exacerbation, with limited function that was graded on the scale 0 to 5. Type and kind of sore shoulder cause was determined by clinical examination and, where needed, by X-ray. Of the total number of cases, 33 patients did not report for follow up examination, 166 patients were forwarded to other physical therapy centers for treatment so the final analysis included 916 patients (82%) whose treatment success was evaluated on the scale 0 to 5. In 659 (58%) patients the inflammation of musculus biceps long tendon was identified as a cause of sore shoulder. The least frequent cause was the blow syndrome (impingement)--20 (2%). In 666 patients (73%) the problem was resolved by local instillation of depo corticosteroids (Betamethason 7 mg) so the physical treatment was not required.


Introduction
Sore shoulder or shoulder region is frequently encountered in general population.According to reference data prevalence ranges between  and  in - age group.A weak bone support enables extensive excursions of this joint and simultaneously reduces its stability.Considering that shoulder movement is supported by numerous joints (gleno-humeral, sterno-clavicular, acromio-clavicular, scapulo-humeral) as well as soft tissues, anatomical and biomechanical complexity of shoulder region may hinder evaluation and treatment of shoulder dysfunction.Th erefore, detailed evaluation of each of the mentioned structures is of utmost importance.Evaluation of spine function in jugular area is of particular importance considering that its dysfunction frequently causes referral shoulder pain.

Material And Methods
We analyzed the results of the treatment of patients suffering from sore shoulder in polyclinic Praxis, in the period  -.Th e treatment outcome was evaluated by successfulness estimation.Th e treatment success is given as an assessment of clinical condition after the treatment objectively evaluated according to the following scale: . grade «» zero: condition unchanged (no results), . grade «»: minimal improvement, . grade «»: satisfactory functional improvement with sequels (sensory or motorical), . grade «»: good improvement and satisfactory functional restitution with minimal sequels, . grade «»: good restitution without consequences of injury or illness.
By retrospective analysis we thus registered and sorted all the patients with sore shoulder who were treated with local instillation and physical therapy procedures in physical medicine polyclinic "Praxis".Accompanying clinical fi ndings and physiological measurements such as functional tests, muscle tonus, pain intensity were used in treatment success evaluation for each individual patient according to the given scale.Th e data are statistically analyzed and presented in Tables and Charts. Results

And Discussion
Between  and  total of  patients reported for examination in the Center for physical medicine and rehabilitation "Praxis".Table  and Chart  illustrate numerical data on structure and type of sore shoulder causes.Inflammation of long tendon of musculus biceps was identified as sore shoulder cause in  () patients.The least frequent cause was the blow syndrome (impingement) - ().Table  and Chart  represent sex structure of the patients that reported for checkup.Th e structure is quite balanced with slight prevalence of female patients.
Total of  patients with dg.M reported for examination and treatment Subjected to physical treatment in "Praxis" polyclinic:  patients (,) Forwarded to other centers for physical treatment:  patients (,) Subjected to physical treatment:  patients (,) Did not report for follow up examination after the intervention:  patients (,) Completed the treatment and evaluated:  patients (,) Relapse:  patients (,) Type and kind of sore shoulder cause was determined by clinical examination and, where needed, by X-ray.
Of the total number of cases,  patients did not report for follow up examination,  patients were forwarded to other physical therapy centers for treatment so the fi nal analysis included  patients () whose treatment success was evaluated on the scale  to . Evaluation of treatment success is presented in Table  and Chart .It is evident that  () patients were successfully treated with grade  and 