Impingement Syndrome of the Shoulder

What is it?
Impingement syndrome occurs when the muscles of the rotator cuff become compressed against the structures of the upper portion of the shoulder. This portion of the shoulder is called the subacromial space. This space eventually becomes smaller in impingement syndrome causing the tendons to rub against the bones that make up the space. The impingement of these structures will eventually cause pain and lead to inflammatory conditions such as tendinitis, bursitis, and/or small tears to the tendons of the rotator cuff. If the impingement becomes advanced it can lead to bone spurs in the subacromial space causing even more pain to the shoulder.

What Causes it?
Prolonged periods of forward posture can lead to impingement syndrome; such as those who work at computer 8+ hours a day. The forward/rounded shoulders when using a computer can cause a narrowing of the sub-acromial space.

Repeated stress or overuse activities such as frequent overhead work or overhead throwing.

Trauma to the shoulder; especially a direct fall onto the shoulder.

Symptoms of Impingement Syndrome
Pain to the anterior front of the shoulder that can radiate to the mid-portion of the arm

Pain with overhead and reaching activities; pain with reaching behind

Pain with throwing and lifting activities

Feeling of weakness when raising the arm overhead

Treatment of Impingement Syndrome
It is important to initially treat the symptoms that can be causing inflammation with this condition in order to help reduce pain. This is followed be general strengthening of the rotator cuff and stretching activities that can help increase the subacromial space. If left untreated it can lead to more serious conditions such as bone spurs and ruptures to the rotator cuff tendon.

If you suspect you have impingement syndrome you should contact your orthopedic or local physical therapist to begin treatment immediately to prevent the condition from worsening.

This is what you should expect during physical therapy:
Manual range of motion exercises performed by your physical therapist to increase range of motion.
Joint mobilizations by your physical therapist to reduce pain and swelling and increase range of motion.
Range of motion and strengthening/stability exercises that will be prescribed by your physical therapist to regain normal function of your shoulder.

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