title: The presence and influence of posterior capsule tightness on different shoulder problems.
abstract: BACKGROUND
  In the literature it has been shown that posterior capsule flexibility is a precursor to shoulder problems. However, no study thus far has shown the influence of the flexibility of posterior capsule in different shoulder pathologies.
  
  
  OBJECTIVE
  This study set about to compare the role of posterior capsule tightness in different shoulder problems.
  
  
  METHODS
  One-hundred-twenty-five patients diagnosed with shoulder subacromial impingement syndrome (n= 52), partial rotator cuff tear (n= 31) or frozen shoulder (n= 42) and 30 asymptomatic peers participated in the study. Horizontal adduction was assessed in side-lying position for posterior capsule tightness. Pain was measured via the visual analogue scale and shoulder range of motion and active total elevation was assessed with goniometer. Hand behind the back (HBB) test was assessed the active internal rotation by measuring the distance between T5 and the thumb.
  
  
  RESULTS
  It was found that the affected side of the posterior capsules of the patients with subacromial impingement syndrome (p< 0.001), partial rotator cuff tear (p< 0.001) and frozen shoulder (p< 0.001) was stiffer than their healthy side. There were significant differences among groups in the level of tightness in the posterior capsule between the affected and the healthy sides (p< 0.001). All range of motion of the shoulder including HBB test and the posterior capsule tightness of the affected side are found to be correlated (p< 0.05).
  
  
  CONCLUSIONS
  This study emphasized that the posterior capsule's susceptibility to tightness is most evident in frozen shoulder among different shoulder problems.
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
authors.forename: Irem
authors.initials: I
authors.lastname: Duzgun
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
authors.forename: Elif
authors.initials: E
authors.lastname: Turgut
authors.affiliation: Department of Physiotherapy and Rehabilitation, School of Health, ÇankırıKaratekin University, Çankırı, Turkey.
authors.forename: Özge
authors.initials: Ö
authors.lastname: Çinar-Medeni
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey.
authors.forename: Nihan
authors.initials: N
authors.lastname: Kafa
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Tuna
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Elbasan
authors.affiliation: Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey.
authors.forename: Deran
authors.initials: D
authors.lastname: Oskay
mesh_terms: D000328:Adult; D000368:Aged; D002062:Bursitis / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology*; D000070636:Rotator Cuff Injuries / Q000503:physiopathology*; D012782:Shoulder / Q000503:physiopathology*; D019534:Shoulder Impingement Syndrome / Q000503:physiopathology*; D012785:Shoulder Joint / Q000503:physiopathology*; D055815:Young Adult
keywords: Posterior capsule; frozen shoulder; partial rotator cuff tear; shoulder impingement syndrome