by Kelly Barrett, DPT
Impingement is one of the most common diagnoses affecting the shoulder joint. We often hear this term, but what exactly is “shoulder impingement?” The joint is made up of three bones called the humerus, the scapula and the clavicle. These bones serve as attachment sites for muscles of the rotator cuff.
When a person is lifting his arm, the space between the acromion (a bony landmark on the scapula) and the rotator cuff becomes narrower. When the acromion rubs against the tendons, it can cause pain and irritation. This pathology often affects those who are involved in repetitive upper extremity motion including swimmers, baseball and tennis players, construction workers, and painters. Shoulder impingement can also develop over time in individuals who have poor posture. For those of you who have “rounded shoulders,” your scapulae may adaptively tilt forward. This will make you back muscles adaptively longer and weaker, your chest muscles tighter, and ultimately create less space for your rotator cuff muscles to glide beneath the acromion.
In the beginning, your symptoms of this pathology will likely be mild, including pain with lifting heavy objects, pain radiating to your mid arm, and pain with reaching movements. Eventually, you may notice difficulty with activities that require arm placement behind the back, pain at night, and even loss of strength and motion.
Surgery is not often indicated for shoulder impingement. The pathology can be corrected with rest, activity modification, and physical therapy. With the appropriate combination of exercises, your physical therapist can help to correct the mechanics of the shoulder so that impingement will be less likely to occur. Exercises like “Y-T-W-Ls” can challenge the core while strengthening the back and shoulder. They can correct adaptive muscle imbalances to create more space under the acromion in an effort to avoid impingement.
If you have any questions about this pathology, or feel that it may even be affecting your life, make an appointment with a physical therapist for an evaluation. A few exercises can go a long way, and may even brighten your day J
Dr. Barrett is a Physical Therapist