Highlights
- •Painful and nonpainful exercises cause a short-lasting increase in shoulder pain
- •Painful isometric exercises evoke no more postexercise pain than pain-free isometric exercises
- •No isometric exercise modality influence shoulder pain sensitivity, strength, or conditioned pain modulation
Abstract
Exercise can reduce pain, however the effect of painful versus non-painful exercises
is uncertain. The primary aim of this randomized crossover study was to compare the
effect of painful versus nonpainful isometric shoulder exercises on pain intensity
after exercise in individuals with rotator cuff-related shoulder pain. Secondary exploratory
aims were to describe the effects on pressure pain thresholds (PPTs), conditioned
pain modulation (CPM) and muscle strength. On separate days, 35 individuals performed
painful isometric shoulder exercises (external rotation; 20% above pain threshold),
nonpainful isometric shoulder exercises (external rotation; 20% below pain threshold),
and a rest condition, in randomised order. Shoulder pain intensity, PPTs, CPM, and
external rotation strength were assessed before, immediately after and 45 minutes
after conditions. No significant differences were observed between painful and nonpainful
exercises. Visual analogue scale scores increased immediately after both painful and
non-painful exercises compared with rest (P = .047, partial ƞ2 = .07), but were similar to preexercise levels after 45 minutes. No changes in PPTs,
CPM, or muscle strength after exercises compared with rest were observed. Painful
and non-painful isometric exercises caused a moderate but short-lasting increase in
shoulder pain in individuals with RCRSP. Isometric exercises had no effect on pain
sensitivity and shoulder muscle strength or CPM.
Perspective
This study evaluated for the first time in individuals with rotator cuff-related shoulder
pain the effects of painful versus non-painful isometric exercises on different pain-related
outcome measures. Both painful and non-painful isometric exercises caused a moderate
but relatively short-lasting increase in shoulder pain in individuals with rotator
cuff-related shoulder pain.
Trial registration number: (ClinicalTrials.gov) NCT03675399
Key words
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Article info
Publication history
Published online: April 19, 2021
Accepted:
March 30,
2021
Received in revised form:
March 30,
2021
Received:
November 7,
2020
Footnotes
Each of the authors has read and concurs with the content in the final manuscript. All authors were fully involved in the study and preparation of the manuscript and the material.
No funding to report for this study.
The authors declare no conflicts of interest.
Data sharing: Data can be retrieved in anonymous form on request to the corresponding author.
Identification
Copyright
© 2021 by United States Association for the Study of Pain, Inc.
