„Shoulder Impingement Syndrome”, the Cause of Shoulder Pain

The most common cause of shoulder joint problems is shoulder impingement syndrome, also

know as subacromial impingement. If you feel growing pain and limitations of the shoulder

joint mobility during exercising or everyday activities, you may be suffering from this

condition.

ANATOMY:

The subacromial space is the shoulder joint area defined by such anatomical structures as:

Superiorly: acromion, coraco-acromial ligament, coracoid process, acromioclavicular joint

Inferiorly: humeral head, greater tubercle of the humerus

Chronic and repetitive compression of the elements within this area may cause lasting pain.

Elements such as: subacromial bursa, supraspinatus tendon, biceps tendon, articular capsule

of the humerus

The elevation of upper extremity, often above the head level, causes significant narrowing of

the subacromial space leading to mechanical compression of the above-mentioned structures.

This motion, if repetitive, can create inflammation and degeneration of the supraspinatus

tendon as well as the other rotator cuff muscles.

ETIOLOGY:

- rotator cuff weakness (supraspinatus, infraspinatus, teres minor and subscapularis muscle).

Properly functioning rotator cuff muscles prevent the humerus head from migrating

upwards, which limits the subacromial space compression

- decreased muscle performance caused by chronic, repetitive process in which upper

extremity is elevated above the head level

- overload training, especially in disciplines like: TENNIS, VOLLEYBALL, SWIMMING

- overload and incorrect exercising technique- especially when it comes to free weights

- acromion morphology (there are three types: flat, curved, and hooked which is associated

with cuff tear)

SYMPTOMS:

- shoulder joint pain during the upper extremity elevation (in sever cases, even the slightest

movement or muscle flex can cause pain)

- limited shoulder joint mobility (shoulder occurs to be stiffer)

- night pain

- rest pain (without doing any activities)

TREATMENT:

There are a lot of treatment methods for the above-mentioned condition. Measures taken early

on to improve health status give the best chance of speedy recovery. Inhibiting inflammatory

process in the early stages helps to prevent degenerative changes in tendons or muscle venters

counted among rotator cuff.

In the severe stage of this condition, it is elementary to concentrate on hindering the ongoing

joint inflammation. It can be achieved with physiotherapy procedures such as:

- Cryotherapy

- Iontophoresis

- Shock wave therapy

- Interferential therapy

- Laser therapy

- Ultrasound therapy

Manual therapy is proven to be vitally important in treating subacromial impingement. By

using manual therapy we can increase the mobility in the constricted joint and loosen soft

tissue, which due to the occurring symptoms, might be overly tensed. Thanks to this

procedure the stiffness in the shoulder joint decreases noticeably.

In our practice, we also use KINESIOTAPING, which is a taping technique that helps to

relieve the strain on muscles and reduce the pain.

The last, and often the most important part of physical therapy are properly selected exercises

that help to strengthen the rotator cuff and the shoulder girdle. Their main goal is to lower the

humeral head and to reduce the compression in the subacromial space. Furthermore, proper

and systematic execution of personalized exercises is the best preventive measure against a

recurrence.

In CORE and MORE we provide complex rehabilitation for patients suffering from „Shoulder Impingement Syndrome” using all methods mentioned above.

If You have some symptoms described in this article or have some problems with daily activities or during sport – we invite You to contact us!