Subacromial Impingement

Types Impingement Syndrome, Bursitis, AC Joint Arthritis/Bone Spur, Rotator Cuff Tendonitis, Biceps Tendonitis, Rotator Cuff Tear (Grades I-IV), Posterior Impingement, Internal Impingement

These diagnoses fall into the overuse or repetitive trauma category and are all very closely related in biomechanical cause.  The shoulder primarily consists of the head of the humerus, scapula, and clavicle.

The clavicle and scapula come together above the head of the humerus (the AC joint) to form a roof.  Between this roof and the humerus is the subacromial space.  In this space sits the tendons of your rotator cuff, biceps, and the subacromial bursa.  When these structures get caught or pinched between the humerus and AC joint, termed impingement, they become irritated and inflamed (tendonitis/bursitis).  Occasionally a bone spur can further crowd the space and increase the incidence of impingement.

Another complicating issue is capsular tightness.  The capsule is essentially the socket of the ball and socket joint.  When the back and bottom portions are tight, they push the humerus closer to the AC joint, again crowding the space.  All of this leads to weakening of the rotator cuff and scapular muscles, which only furthers the problem.

Rehab Focus Reverse any and all of the above issues by making sure the capsule is loose, the space is open, the scapular muscles are working appropriately, and finally the rotator cuff is doing its job.  Your therapist will manually stretch your capsule, help you regain muscular control, and show you some positions of comfort.  Active rest is the key, meaning do nothing that hurts and everything that doesn’t.