​What is shoulder impingement?

Jun 01, 2020

Shoulder impingement syndrome is a generalized term to refer to pain and pathology due to compression of tendons and soft tissue in the shoulder region.

Most commonly the diagnosis is referring to subacromial impingement where the space between the acromion and the humeral head is narrowed (see picture below). This frequently entraps tendons of the rotator cuff muscles (particularly supraspinatus and infraspinatus) and/or the long head of the biceps brachii. Typically, you will have pain with lifting your arm either in front or to the side, particularly in the mid-range of that movement. Another provocative position being: arm lifted to 90 degrees, reaching across to opposite shoulder and then lifting the elbow higher than the shoulder. It may be painful to lie on that shoulder. Sometimes weakness or decrease in the arm movement can occur as well. There are two major types of impingement: external and internal.

External

  • Pain is usually in the front or side of the shoulder
  • Can be caused by osteophytes (bone spurs)
  • The shape of the acromion can cause decreased joint space
  • Decreased scapular stability
  • Forward rounded posture

Internal

  • Pain is usually in the back of the shoulder
  • The rotator cuff tendons rub against the labrum
  • Common in overhead athletes

Conservative intervention is the recommended treatment. If initiated early, tearing of the tendons may be avoided. The focus of treatment will be on both mobility and strength/stability. There are several joints in the shoulder region, your provider will likely perform mobilization techniques to maintain normal movement of these joints. We will also focus on the range of motion in your shoulder. Not only the ability to lift to normal heights, but focusing on the quality and efficiency of the arm and scapular movements. Lastly, we must restore strength and stability. Activities will involve scapular stabilization, isometrics and activity specific exercises.

Check out this *****video***** for some workout do’s and don’ts regarding shoulder impingement.

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