An intro to Shoulder Impingement

Introduction

Carrying on with the Shoulder Month, this week’s article will look more into what exactly is “Shoulder Impingement”. One of the most common scenarios that we come across in our clinic is patient’s google diagnosing themselves with Shoulder Impingement and breaking into a sweat about it. In view of this, we thought a blog article might help make this topic a little bit more clearer.

Before we start, we must stress that this is not a substitute for a physiotherapy session or a consult with your doctor. This article targets the general population and it is important to understand that your problem/pain is not general and individualized. Please seek appropriate medical help as required or give us a call/come visit us.

What exactly is a Shoulder Impingement Syndrome?

Shoulder Impingement or otherwise known as Subacromial Impingement is when the soft tissue in the shoulder is “impinged” or trapped between the humerus (our arm bone) & the acromion (the top of our shoulder) . Supraspinatus (one of the four rotator cuffs) is often the most common soft tissue that gets impinged. This impingement causes mechanical irritation of the rotator cuff and will result in pain, swelling and damage to the affected tendons. This could even eventually lead to a tear of the supraspinatus tendon from prolonged irritation.

Presentation of Shoulder Impingement

Shoulder impingement pain is usually insidious  but can sometimes also arise from trauma. Patients usually complain of pain felt/aggravated when the arm is elevated to shoulder level and often also complain of weakness secondary to the pain. Tasks such as putting on your clothes, combing your hair or reaching into your cupboard often become painful and source of stress and discomfort. Other common symptoms reported are pain at night time with disturbed sleep and pain made by lying on it.

Why me? What causes “Shoulder Impingement?”

Fortunately shoulder impingement is better understood due to advances in science and technology which has led to a better understanding in why shoulder impingement occurs. This has led to a more individualized and specific rehabilitation of the injured shoulder rather than a generalized one. There are multiple causes of shoulder impingement and we will be looking into the following: primary & secondary causes of shoulder impingement.

Primary

  • Results secondary to abnormalities in anatomical structures.
  • This could be congenital (from birth) or due to formation of structures such as bone spurs.

Secondary

  • Caused not by anatomy abnormalities by more by what the person may be doing
  • Activities/postures that lead to poor movement, tightness of muscles, muscular imbalance and decreased control can also lead to shoulder impingement.

The above 2 are causes are types of external impingement. Internal impingement can also occur:

Internal Impingement

  • Occurs mostly in young athletes/overhead athletes.
  • Occurs when the shoulder is placed into 90 degrees of abduction & external rotation (during a throwing the ball phase).
  • This movement causes 2 of the rotator cuffs (supraspinatus & infraspinatus) to rotate.
  • This rotation leads to tendon rupture and irritation.

Finally...

As you know now, there are many different causes of shoulder impingement and it is very unlikely that there are two that present exactly the same. It’s important to seek help from a professional who can help assess the problem to identify the root causes.In essence, treatment should be individualized in order for appropriate rehab and recovery!

With you every step of the way,

The Physiotherapist

East Coast Practitioners.