Impingement Syndrome
Post Rehab Goals and Objectives:
- Improve Shoulder Flexibility
- Improve Functional Capacity of the Shoulder
- Improve Shoulder Rotator Cuff Strength
- Improve Posterior Shoulder Girdle Strength
Description
Impingement Syndrome is characterized by shoulder pain that occurs when the client moves the arm into an overhead position. The pain occurs between 70-120 degrees of elevation or adduction. The Impingement occurs when the greater tuberosity of the humerus abuts the acromion process. This will impinge the subacromial bursa; inflame the supraspinatus tendon, and/or cause erosion or a tear of the rotator cuff.
The Impingement may be caused by weakness of the rotator cuff and the posterior shoulder girdle muscles. The rotator cuff acts to stabilize the humerus in the glenoid fossa. The rotator cuff prevents the humeral head from migrating superiorly within the glenoid fossa during overhead activities. The posterior shoulder girdle muscles stabilize the scapula against the thorax to provide the humerus with a foundation of stability for overhead movement.
Chronic impingement may cause the sheath of the rotator cuff to be worn away and partially or completely torn. A tear may cause the loss of full function in the shoulder. Chronic impingement is usually seen in clients who participate in racquet sports, swimmers, or any one performing frequent overhead activities. Typically the symptoms of impingement are pain with overhead activities from 80-120 degrees and limited strength with activities over 90 degrees.
Shoulder impingement may last for years. For those clients participating in high level of sports or in occupations requiring overhead activities, surgery may be a necessary option. The shaving of the acromion or the removal of the acromion (acromionectomy or shoulder decompression) is the two options for surgery. Both conservative and surgical management require strengthening of the rotator cuff and posterior shoulder girdle.