What is a Shoulder Impingement?

A shoulder impingement is a very common condition, whereby certain tendons in the shoulder (rotator cuff tendons) are very briefly compressed during certain movements. The compression occurs when bony structures come into contact with the tendon or the bursa. This may result in a person experiencing pain or a pinching sensation in the shoulder joint during certain shoulder movements.

When this ‘pinching’ or compression occurs frequently, the soft tissue, tendons and even the bursa can become irritated and damaged. This often times can give rise to conditions such as tendinopathies (injury to tendon), bursitis and in the long run lead to rotator cuff tears.

The Causes of Shoulder Impingement

Poor movement patterns, muscle imbalances and tightness can result in dynamic instability within the shoulder and create impingement. In other terms, if there is movement that is not optimal or if certain muscles are weak or not functioning appropriately it can create an impingement.

Sometimes the space where tendons lie in (sub-acromial space) can become physically narrowed by bony spurs, which can increase the likelihood of tendons coming into contact with bones.

Who is at risk of Getting Shoulder Impingements?

Jobs that require repeated overhead movements and activity can be a trigger for shoulder impingements; often times manual labourers such as electricians and ceiling fixers are at higher risk. At the same time sedentary tasks with a combination of poor shoulder posture can also place an individual at risk. As such office workers who spend a large amount of time with hands near shoulder level are also at risk.

In the sporting world shoulder pain and impingement is also commonly experienced by Weight lifters, Tennis players, Baseball players, cricketers and Swimmers.

How do we diagnose Shoulder Impingements?

Your Physiotherapist is able to diagnose shoulder impingement in clinic itself. This is done via a combination of listening to your presenting complaint, a physical examination and movement screening.

Occasionally a medical scan (Ultrasound, MRI, or X-Ray) may be required to confirm the diagnosis.

Next time we will discuss the common signs, symptoms and treatment of Shoulder Impingements.

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