• Lionel Pannunzio PT / SCS

Shoulder Impingement - Learn what to do to improve that nagging shoulder pain...




𝐀𝐧𝐚𝐭𝐨𝐦𝐲 𝐨𝐟 𝐭𝐡𝐞 𝐢𝐧𝐣𝐮𝐫𝐲

The shoulder is made up of 3 bones called the humerus, the scapula, and the clavicle. The acromion is a bony prominence on the top of the scapula, which can be felt as a bump at the tip of the shoulder.

The rotator cuff tendon and the bursa sit beneath the acromion. The bursa is a fluid-filled sac that provides a cushion between the bony acromion and the rotator cuff tendon to reduce friction between these tissues.

Shoulder impingement syndrome occurs as the result of chronic and repetitive compression or "impingement" of the rotator-cuff tendons in the shoulder with overhead arm movements, causing pain and movement problems.

It can also be caused by an injury to the shoulder.

People who perform repetitive or overhead arm movements, or athletes who raise their arms repeatedly overhead (ie, Swimming , Golf, Crossfit , Racquet Sports, Basketball players and Baseball pitchers), are most at risk for developing a shoulder impingement.

Poor posture can also contribute to its development.

If left untreated, a shoulder impingement can lead to more serious conditions, such as a rotator cuff tear.

Shoulder impingement syndrome may also be referred to as "subacromial" impingement syndrome because the tendons, ligaments, and bursa under the "acromion" can become pinched or compressed, and it can become compressed underneath the acromion.

Impingement symptoms can occur when compression and micro-trauma harm the tendons.



𝐂𝐀𝐔𝐒𝐄𝐒 𝐎𝐅 𝐒𝐇𝐎𝐔𝐋𝐃𝐄𝐑 𝐈𝐌𝐏𝐈𝐍𝐆𝐄𝐌𝐄𝐍𝐓





Shoulder impingement syndrome occurs as the result of chronic and repetitive compression or "impingement" of the rotator-cuff tendons in the shoulder with overhead arm movements, causing pain and movement problems.



There are several causes of shoulder impingement syndrome including:



  • Poor rotator cuff and shoulder blade muscle strength, causing the humeral head to move abnormally.

  • Tightness of the soft tissue around the shoulder joint called the joint capsule.


  • Repetitive overhead movements, such as golfing, throwing, racquet sports, and swimming, or frequent overhead reaching or lifting.


  • Injury, such as a fall, where the shoulder gets compressed.


  • Bony abnormalities of the acromion, which narrows the subacromial space.


  • Osteoarthritis in the shoulder region.


  • Thickening of the bursa.


  • Thickening of the ligaments in the area.



The good news is that most of this causes can get better with a comprehensive physical therapy program to address the weakness and tightness associated with the rotator cuff.


Passive treatments like medications , injections , acupuncture , massage , will help partially but it is not until the shoulder recovers the full movement and gets stronger that pain will improve for good.



HOW DOES IT FEEL?


Restriction , weakness and pain with shoulder motion such as reaching overhead, behind the body, or out to the side.


Pain in the shoulder when moving the arm overhead, out to the side, and beside the body.


Pain and discomfort when sleeping  on the involved side.

Pain with throwing motions and other dynamic movement patterns.


How Is It Diagnosed?


A physical therapist will perform an evaluation and ask you questions about the pain you are feeling, and other symptoms. Your physical therapist may perform strength and motion tests on your shoulder, ask about your job duties and hobbies, evaluate your posture, and check for any muscle imbalances and weakness that can occur between the shoulder and the scapular muscles.

Special tests involving gentle movements of your arm and shoulder may be performed to determine exactly which tendons are involved. X-rays may also be taken to identify other conditions that could be contributing to your discomfort, such as bony spurs or abnormalities, or arthritis.




Conclusion:

  • Shoulder impingement is when the soft tissues ( muscles , bursa , tendons) are being "pinched" in between the bones of the shoulder causing pain when raising the arm.

  • Usually muscle weakness, poor posture and tight chest muscles can contribute to this condition.

  • Solving this condition requires a comprehensive approach to correct all deficits that can be causing the shoulder dysfunction and pain .



Lionel Pannunzio is a Physical Therapist Certified in Sports Injuries.

With more than 20 years of experience helping athletes return to their sports after an injury.

He is the Owner of White Bay Sports Physical Therapy and Fitness, conveniently located  in the beautiful City of Weston, where he treats Soccer Player, Runners and Athletes of all ages

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Lionel Pannunzio

Physical Therapist

Board-Certified Sports Specialist

Owner of White Bay Physical Therapy



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