Shoulder Impingement - PDF by alendar


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									                                 Shoulder Impingement

                                    Subacromial space

Shoulder Impingement may occur when the rotator cuff
tendons are impinged as they pass through the
subacromial space (between the bony processes of the
shoulder blade and the ball of the arm bone). This
impingement causes mechanical irritation and results in
swelling and damage to the tendons.

Related factors
Shoulder impingement is associated with overuse and/or
altered shoulder mechanics. Overuse may occur from repetitive activities such as swimming and
throwing sports or overhead manual tasks such as painting. Altered shoulder mechanics may be due to
tight muscles or soft-tissue structures, or reduced strength of the rotator cuff muscles. Impingement
occurs when the subacromial space is narrowed. There are many factors that can lead to narrowing of
the subacromial space which include poor shoulder mechanics, subacromial spurs, calcification of
surrounding soft-tissues, superior migration of the arm bone, adhesive capsulitis, and thick
subacromial bursa.

How physiotherapy can help
Physiotherapy can help by addressing the factors that are contributing to the tendinopathy and may
include soft-tissue massage, stretches, strengthening exercises for the rotator cuff and retraining of
correct shoulder mechanics.

1. Stretches
        - Hold for 20 seconds, 4x each side

           Pectoral stretch                   Latissimus dorsi               Posterior capsule

2. Rotator cuff strength
       - Ensure that you maintain a good position of your shoulder blade throughout these exercises
         (shoulder blades down and in)
       - Repeat each exercise 10-15 times
Start position                           External rotation                  Internal rotation

                     Forwards (flexion)                  Backwards (extension)

3. Rotator cuff control

   Scapular stability (write alphabet)                 Wall push ups (double or single arm)

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