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Shoulder Impingement Syndrome

Shoulder pain is a common complaint, especially for those of us whose leisure and occupation require repetitive overhead motion. Whether it’s landscaping, painting, exercise, or throwing, repetitive overhead use can put strain on your shoulder. The structure of the shoulder joint is similar to that of a ball and socket, allowing for a wide range of motion, making it the most mobile joint in the body.(1) This wide range of motion; however, comes with a price. Overhead activity requires an adequate balance of shoulder mobility with dynamic stability to prevent injury.

Shoulder Anatomy

The shoulder joint is complex; it requires synchronous movement from your humerus (upper arm bone), scapula (shoulder blade) and clavicle (collar bone). The head of the humerus fits into a rounded socket on your scapula (you can think of this as a golf ball on a tee), while the clavicle forms a joint with the scapula to allow for additional motion. The rotator cuff is the dynamic stabilizer of the shoulder; it is made of up four muscles and is responsible for providing stability of the shoulder joint.(2) The bursa lies between the rotator cuff and the acromion (top of the scapula) to allow for smooth motion.

Shoulder Impingement

You may have heard of shoulder impingement syndrome. Impingement occurs when subacromial space narrows and compression of the tendon and bursa results. This can occur when imbalances (either tightness, or weakness) of the scapular, back, and chest muscles alters the normal movement pattern of the shoulder joint. As you raise your arm, the subacromial space naturally narrows; this is especially true at 90 degrees abduction, or when your arm is at shoulder height and out to the side. (3) However if space narrows too much it will cause pinching of the tendons an bursa, this can turn into a vicious cycle of pain and inflammation.

Impingement of the shoulder is common, accounting for 44-65% of all shoulder complaints in primary health care.(4) f you are looking for ways to improve your shoulder health and prevent or reverse shoulder impingement symptoms, take a look at the video below. You can learn what exercises are ideal in maintaining shoulder health!

If you are dealing with shoulder pain during your daily life, click the link below to schedule your free discovery visit with a Physical Therapist.

1. Quillen DM, Wuchner M, Hatch RL. Acute shoulder injuries. Am Fam Physician. Nov 15 2004;70(10):1947-54.
2. Escamilla RF, Hooks TR, Wilk KE. Optimal management of shoulder impingement syndrome. Open Access Journal of Sports Medicine. 2014;5:13-24.
3. Graichen H., et al. Subacromial space width changes during abduction and rotation- a 3/D MR imaging study. Surg Radiol Anat. 1992:21(1):59-64.
4. Van der Windt D.A., et al. Shoulder disorders in general practice: prognostic indicators of outcome. Br J Gen Pract. 1996; 46:519-523.