Impingement Syndrome

Image of shoulder bones as they pinch a muscle through a painful arc
What is it?

Impingement is another term for pinching or compression on a structure within the body. You can have an impingement issue in many areas of the body. Muscle imbalances, increased inflammation or injury can all be causes of impingement. These issues can resolve on their own or require targeted treatment.

The Anatomy

One of the more common impingement syndromes we see is in the shoulder. The shoulder is a complex joint with very minimal excess space and lots of moving parts. The subacromial space, as noted above in the picture is where the supraspiantus tendon lies. This is one of four muscles that makes up your rotator cuff. Common complaints of this injury involve shoulder pain, a painful arc while moving the shoulder, and night pain.

Possible Causes

This structure can be damaged in a number of ways. Typically an impingement syndrome indicates chronic issues or over use. However, an acute injury can lead to this over time without the proper rehab early on. The shoulder joint is a ball and socket style joint. This allows the joint to be very mobile. However, with increased mobility comes decreased stability. When the shoulder joint is not moving as desired it can lead to compression of structures. 

Below indicates a situation where the subacromial space has been filled with inflammation or irritation. As the shoulder moves up, the space naturally closes down. However, if something is already filling that space, such as swelling, the tendons will not be able to glide correctly. This will lead to the pinch or pain we get in the shoulder. 

Treatment

Prior to treatment it is important to be evaluated by a medical professional to ensure there isn’t a tear. This can be done by imaging or your local physical therapist. In many instances there is a mechanical issue in the shoulder that requires some stretching and strengthening of specific muscles. This will improve stability and decrease the stress. Other instances will require anti-inflammatory medication, manual therapy, and rest to help decrease swelling in the shoulder. Once the initial irritation is gone, we can start promoting proper shoulder range of motion.

Follow Up

If this is something you have been dealing with for a while consult with your healthcare provider. Impairment can cause added stress on the muscles and eventually lead to full tears. These will require surgery and be costly. Take action now and don’t let your shoulder pain turn into more problems.

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