Subacromial pressures vary with simulated sleep positions.
OBJECTIVE
Subacromial impingement is one of the underlying factors of rotator cuff pathologies and is linked to increased subacromial pressures. Because humans spend about one-third of their life sleeping, we hypothesized that distinct shoulder positions while sleeping may considerably influence nocturnal subacromial pressures. Consequently, atrophy and rupture can affect tendon healing after rotator cuff repair, thus potentially discrediting the outcome of surgery.


METHODS
We determined the subacromial pressures acting on the rotator cuff in the 4 most common sleep positions and related these pressures to the mean arterial blood pressure and physical examination findings in 20 healthy volunteers.


RESULTS
Subacromial pressures were significantly lower in participants sleeping preferably in a supine position than in participants sleeping in side or prone positions (P < .005).


CONCLUSIONS
As tendon perfusion is crucial for tendon-to-bone healing during postoperative physical therapy after rotator cuff reconstruction and for prevention of additional damage to healthy or already torn cuffs, potential clinical relevance may emerge from the present study.


CONCLUSIONS
Distinct shoulder positions considerably influence subacromial pressures. Our findings may be considered in physiotherapeutic concepts after rotator cuff surgery.
Werner
Clément M L
CM
Department of Surgery, Division of Trauma Surgery, University Hospital Zurich, Zurich, Switzerland.
Ossendorf
Christian
C
Meyer
Dominik C
DC
Blumenthal
Stephan
S
Gerber
Christian
C
D001284:Atrophy; D001794:Blood Pressure / Q000502:physiology; D006801:Humans; D011312:Pressure; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000473:pathology / Q000601:surgery; D000070636:Rotator Cuff Injuries; D019534:Shoulder Impingement Syndrome / Q000503:physiopathology; D012785:Shoulder Joint / Q000502:physiology*; D012890:Sleep / Q000502:physiology*; D016683:Supine Position / Q000502:physiology