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Assessment of rotator cuff muscle strength and shoulder rotation range of motion in subjects with lateral epicondylitis

Background: Lateral epicondylitis (LE) is a common soft tissue condition treated by many physical therapists. It has poor long-term outcomes for the non-surgical management which suggests a less than optimal rehabilitation process, so there is a need to assess proximal kinetic chain. 
 
Objectives: The objective of the study is to compare shoulder rotator muscle strength and shoulder rotation range of motion (ROM) in patients with LE with age-matched healthy individuals. 
 
Materials and Methods: An observational study was conducted on 28 subjects with LE (Group A) and 28 age-matched healthy individuals (Group B), selected by convenience sampling. The strength of shoulder rotator muscles was assessed with the use of handheld dynamometer. Shoulder rotation ROM was assessed using standard goniometer. 
 
Results: Shoulder external rotators were 9% weaker on dominant side (P = 0.02) while no differences were seen for shoulder internal rotator (IR) strength (P = 0.2). For Group B, shoulder external rotators were 11% stronger on dominant side (P = 0.04), while No dominance difference was seen for shoulder IR strength (P = 0.5). For both Group A and Group B, shoulder rotation ROM showed no significant difference between dominant and non-dominant sides. For between-group analysis, shoulder rotation ROM and shoulder rotator strength showed no statistically significant difference between the Groups A and B. 
 
Conclusion: There is muscular imbalance of shoulder rotators in LE.