Tuesday, 30 September 2014

Shoulder Impingement Syndrome

In my last blog, I discussed rotator cuff injuries, which develop as a result of chronic tears of the four rotator cuff muscles, which is caused by repetitive microtrauma to these muscles as a result of overuse.

Impingement syndrome of the shoulder occurs when the supraspinatus muscle or tendon becomes impinged, or trapped, under the acromion process during overhead movements. The condition can also be referred to as “painful arc” syndrome or “swimmer’s shoulder”.

Symptoms
Depending on the severity of the impingement syndrome, the following symptoms may be present:
·         Pain and weakness in and around the shoulder joint
·         Limited range of movement in the shoulder joint
·         Clicking in the shoulder during movement
·         Increased pain when the arm is lifted up to the side between 70 and 120 degrees (called the “painful arc”)

Risk Factors
The following factors may increase the risk of developing impingement syndrome:
·         Excessive overhead movements (for example, swimming and cricket bowling)
·         Anatomical limits that result in limited flexibility of the ligaments around the shoulder
·         Anatomical shape of the acromion process
·         Increased thickness of the supraspinatus and biceps brachii tendon
·         Lack of flexibility and strength of both the supraspinatus and biceps brachii muscles
·         Weakness or tightness of teres minor and infraspinatus
·         Hypermobility of the shoulder joint
·         Imbalances in the strength, coordination and endurance of muscles supporting the shoulder joint and scapulae
·         Training devices, such as hand paddles in swimming

Management
·         Rest, ice and non-steroidal anti-inflammatory drugs
·         Physiotherapy to reduce inflammation and increase range of movement
·         Modify activity to movements that do not cause pain
·         Biokinetic therapy to correct imbalances in muscle strength and coordination and to assist in returning to normal activity, including sport activities

References
Foundations of Athletic Training: Prevention, Assessment and Management

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