Shoulder Impingement / Rotator Cuff Injury
What is Shoulder impingement?
Shoulder impingement occurs when the rotator cuff tendons are injured as they pass through the space beneath the point of the shoulder. This impingement can cause irritation of the tendons resulting in shoulder pain and possible eventual damage. Rotator cuff injury/impingement is a ‘clinical sign’ not a diagnosis. In severe cases a rotator cuff tear my be present.
Shoulder impingement sysmptoms
Primary external impingement: caused by an abnormally hooked acromion narrowing the space between the acromion and shoulder. This is usually a result of congenital abnormality at birth or osteophyte formation developed over time.
Secondary external impingement: excessive angulation of the scapula (shoulder blade) due to inadequate muscular stabilisation of the scapula. Weakness/imbalance of the rotator cuff muscles leading to shoulder joint instability. This imbalance can cause the humeral head to move in such ways to cause an impingement.
Internal impingement: also known as glenoid impingement, where the under surface of the rotator cuff impinges against the posterior – superior surface of the glenoid. This mainly occurs in overhead athletes.
Shoulder impingement symptoms
- Pain at the front or side of shoulder
- Catching or painful ‘arc’ of movement when elevating the shoulder
- Painful with overhead movements
- Restriction in movement
Shoulder impingement treatment
- Speci fic rotator cuff strengthening, beginning with strengthening in the neutral position, and progressing to strength through range
- Scapula stabilisation work – strengthening muscles such as lower trapezius, serratus anterior, and subscapularis
- Taping- speci fic taping techniques can be used to improve positioning and support of the shoulder joint and scapula, while providing feedback for the muscles, and pain relief
- Manual techniques – including mobilisations to the thoracic spine to improve mobility, mobilisations of the shoulder joint and soft tissue massage to tight muscles.
- Advise regarding posture, and modi cation of activities.
Managing shoulder impingement
- Rotator cuff exercises prescribed by your physiotherapist targeting the rotator cuff muscles (often using resistance bands)
- Avoiding aggravating activities
- Maintaining good posture