Differences in scapular orientation,subacromial space and shoulder pain between the full can and empty can tests

Background

The empty and full can arm positions are used as diagnostic tests and in therapeutic exercise programs for patients with subacromial impingement syndrome. The adverse effects of these arm positions on the rotator cuff have not been fully described. The purpose of this investigation was to compare the acromio-humeral distance, three-dimensional scapular position, and shoulder pain during maximum isometric contractions in the empty and full can arm positions.

Methods

Subjects with subacromial impingement syndrome (n = 28) and a matched control group without shoulder pain (n = 28) participated. Acromio-humeral distance, scapular/clavicular positions and shoulder pain were measured during maximal isometric contractions in each position.

Findings

No difference was found in acromio-humeral distance (P = 0.314) between the arm positions or between the groups (P = 0.598). The empty can position resulted in greater scapular upward rotation (P < 0.001, difference = 4.9°), clavicular elevation (P < 0.001, difference = 2.7°), clavicular protraction (P = 0.001, difference = 2.5°) and less posterior tilt (P < 0.001, difference = 3.8°) than the full can position. No differences in the scapular positions were found between the groups. Positive correlations were seen between the scapular positions in the control and not in the subacromial impingement group.

Interpretation

Our results did not show a difference in acromio-humeral distance between the arm positions or groups, indicating that the kinematic differences between the positions are not associated with altered acromio-humeral distance. The increased pain in the EC position might be due to the lack of an association amongst the scapular positions rather than the deficiency of a single scapular motion.