Conditions
Shoulder impingement is caused by pinching and compression of the rotator cuff tendons and the bursa (fluid filled sac) against the acromion (part of the scapula).
Impingement may result from a number of reasons including:
- Poor control of the scapular stabilising muscles and rotator cuff muscles
- Poor postural position of the scapula
- Tight muscles around the shoulder joint
- An altered shape of the acromion or a spur. The extra bone reduces the space for the tendons and bursa. This can require arthroscopic surgery to correct.
Chronic impingement is common in occupations that require repetitive lifting, especially where overhead tasks are performed. Sports that involve throwing (baseball, cricket) or repetitive overhead motion like swimming and tennis are also causes of impingement.
Management is based on accurate diagnosis of the underlying cause of the impingement. A large feature of physiotherapy management involves stability training of the scapular and rotator cuff muscles to restore normal movement patterns and reduce the risk of re-injury.