What is impingement? you ask. Read on to find out.
Shoulder Anatomy
The shoulder is a complex structure comprised of tendons, ligaments, muscles, joints and bursa. The connections between the arm bone (humerus), collar bone (clavicle), shoulder blade (scapula) and the rib cage provide us with a base for an arm that is able to move through a wide range of motions. Having large ranges of motion allows us to reach the back of our head to wash our hair and reach our backs to tuck in shirts or put on a belt. In order to achieve this level of movement, the shoulder has to be less stable, and this leaves it prone to injury.
The arm bone and shoulder blade form the ‘ball and socket’ joint of the shoulder. This is where most shoulder movement takes place. The ligaments between these bones are mobile and a group of muscles known as the ‘rotator cuff’ muscles help to keep the ‘ball’ of the arm bone positioned correctly over the ‘socket’ of the shoulder blade.
Subacromial Space, Often the Area of Impingement
Over the top of the ball and socket joint sits the ‘acromion’, a bony prominence of the shoulder blade which creates a roof over the joint. Between the top of the ball and the bottom of the acromion is a small space called the ‘subacromial space’. Tendons of the arm muscles that produce shoulder motion pass through this space and attach to the bones of the arm. Also in this space sits a ‘bursa’, which is a small sac of fluid which helps to keep movements around joints smooth and frictionless. There are a lot of tissues in this small space which can become “pinched” and irritated.
Signs And Symptoms of Shoulder Impingement
Signs and symptoms of shoulder impingement include:
- Pain with arm movements (particularly movement in front and out to the side of the body)
- Pain with shoulder rotation
- Pain that radiates down the outside of the upper arm
- Reduced shoulder range of motion
Causes of Shoulder Impingement
Common causes of shoulder impingement include:
- Repetitive overarm throwing or other above-shoulder activities
- Long-standing poor posture or poor movement patterns
- De-conditioned or weak shoulder muscles
- Repetitive heavy lifting
Anything that may irritate the structures which pass through the subacromial space can result in pain, swelling, and impingement. Any of the above-mentioned structures can become inflamed, but there is rarely just one tissue solely responsible.
Treatment
The underlying causes of most shoulder impingement is inefficient shoulder movement. During your appointment with our specialists, we will look perform a comprehensive assessment to determine all contributing factors to your shoulder pain and impingement. This will include examination of not only the shoulder, but the neck and mid-back areas of the spine as well.
Through a combination of hands-on treatment and progressive exercises and lifestyle modifications, you can expect to see improvements in your pain and range of motion. Our physical therapists will guide you through the entire process to assure you attain your goals and reduce the risk of recurrence of your pain.
If you have been diagnosed with or have symptoms of shoulder impingement, do not continue to suffer from the pain. Call our office and get started on the road to recovery today!
