Impingement syndrome is the most common shoulder problem seen in athletes. This consists of irritation to the rotator cuff tendons and/or the long head of the biceps tendon. During combined shoulder movements of flexion, abduction, and rotation these tendons may become compressed. There is still some controversy that surround the exact cause of impingement but we can break it down into two categories: primary and secondary. Primary impingement refers to situations in which there are anatomical structures interfering with the mobility of the shoulder like the shape of the AC joint. Secondary impingement can occur when there is an imbalance or weakness in the muscles stabilizing the scapula or those of the rotator cuff itself. This is the most common cause in the athletic population.
Clinical presentations of impingement syndrome can vary. In the initial stages an athlete may complain of a vague localized deep ache in the shoulder, particularly following overhead activity. Throwing sports and weight lifters are particularly vulnerable. A classic sign of impingement syndrome is a person’s shoulder is uncomfortable and painful to lie on at night in bed. As the condition progresses, there will be pain during and after exercise and can get to the point where the pain prevents an athlete from doing any exercise.
A self-test can be done to evaluate the shoulder. Simply keep the arm at your side with the hand pointing to the floor and then raise the arm side-ways and finish with the fingers pointing to the ceiling. Think of a clock during this test. Your hand starts at 6 o’clock and finishes at 12 o’clock. If there is pain between 2 and 4 o’clock when raising your arm, there is a very good chance that you have shoulder impingement.
If you have this painful arc, it’s important to seek conservative or medical care because if it is caught early there are many treatment options to correct this and avoid more serious injuries like rotator cuff tears or bicep tendon ruptures. It’s also important to stop certain exercises if you’re an overhead athlete. These include bench pressing with a straight bar, Lat pull downs behind the neck, overhead pressing, upright rows, and holding objects in the front rack position! These exercises cause impingements in the shoulder! It’s important to have your shoulder evaluated and treated on a regular basis until symptoms subside. There are several effective exercises that should be performed daily by someone who has a shoulder injury because the shoulder is the most mobile joint in the body and the most used joint in the body. Don’t wait for the pain to go away, get it evaluated today!
Hyde, T. E., & Gengenbach, M. S. (2007). Conservative management of sports injuries. Jones and Bartlett Publishers.
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