The Effect of Electrical Stimulation Cueing in a Competitive Powerlifter with Shoulder Pain and Scapular Dyskinesis: A Case Study

Abstract

Background: Shoulder conditions are a common musculoskeletal complaint. The presence of scapular dyskinesis has been shown to result in 43% increase in shoulder pain in athletes. It is known that peripheral ES changes muscle behavior. There are no studies that examine exercise with triggered ES to the lower trapezius, to address shoulder pain and scapular dyskinesis. Methods: The purpose of this case study was to demonstrate that specific parameters with triggered ES, combined with 3 exercises, would result in meaningful improvement in shoulder function and pain in a 22-year-old powerlifter with chronic shoulder pain and scapular dyskinesis. The patient received 6 treatments of trigger switch cued ES and exercise plus four manual therapy sessions. A biphasic-pulsatile current was used. The frequency and pulsewidth were 25 pps and 250 usec, respectively. The intensity was comfortable and produced scapular retraction. Results: Improvements were noted in all outcomes. Numeric Pain Rating Scale was decreased to 1/10. Left shoulder passive range of motion was returned to 100%. The Quick Dash Disability score improved from 38.6% to 2.27%. The Quick Dash Work Module score improved from 6.6 to 0, the Quick Dash Sport Module score improved from 37.5 to 0. The Patient Specific Functional Scale score improved from 3.7 to 8.3. Thoracic spine to scapula distance differences occurred at the following shoulder abduction angles: -0.7 cm at 0, -0.1 cm at 45, +0.4 cm at 90, and -0.5 cm at 120. Conclusion: Trigger switch ES and 3 exercises, plus traditional manual therapy, resulted in improvement in all self-report outcome measures and a change in thoracic spine to scapula distance in a patient with shoulder pain and scapular dyskinesis who had failed to improve by traditional physical therapy.