Movement System Impairment Syndrome - Based Diagnosis and Treatment in Patients with Shoulder Hypomobility: A Case Report

Abstract

Introduction:

Two-thirds of people experience some form of shoulder pain in their lifetime. Sahrmann’s MSI method examines movement patterns rather than structural damage to identify the type of shoulder pain an individual is experiencing. The primary goal for diagnosing shoulder pain is to locate the specific movement(s) that cause the pain and then correct them through movement retraining and proper alignment.

Materials and Methods:

A 59-year-old woman presented with left shoulder pain without a history of trauma for 3 months, which has been increasingly troublesome while sleeping and doing overhead movements and activities. Using a Movement System Impairment (MSI) approach, the patient participated in a four-week physiotherapy programme that consisted of three sessions per week. Physiotherapy aimed to reduce the patient's pain, improve their range of motion in the shoulder and rectify the abnormal patterns of movement associated with this condition. Treatment included education, exercise, manual therapy and the use of modalities for pain control.

Results:

At the end of 4 weeks of MSI-guided physical therapy, the patient showed significant improvement in shoulder pain and impairment. A marked pain relief was demonstrated by an NPRS score change from 8 to 0. Significant reductions were also evident in the SPADI scores, with overall improvements from 91% to 16.8%, disability reductions from 90% to 17.5%, and pain reductions from 92% to 16%. Clinically, the patient reported increased scapular control, an increase in range of motion, improved sleep patterns, and the ability to work overhead and perform daily functional activities with minimal discomfort.

Conclusion:

For a patient with Glenohumeral Hypomobility Syndrome, the MSI-based physiotherapy program effectively reduced pain and disability.