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  • Writer's pictureDr. Alex Tapplin

Shoulder Impingement

Updated: Sep 26, 2023

Here are a few simple but excellent exercises for shoulder impingement, subacromial shoulder pain, posture related shoulder pain and/or rotator cuff tendon problems.



An Update On Shoulder Impingement:


  • Traditional View: Structural compression focus.

  • Updated View: Emphasizes movement and biomechanics.


Shoulder impingement is a common ailment affecting many individuals, especially those engaged in repetitive overhead activities. Traditionally, it has been viewed as a structural issue, focusing on compression within the shoulder joint. However, a growing body of evidence and a shift in perspective among healthcare professionals highlight the dynamic nature of shoulder impingement. This alternative viewpoint broadens our understanding, taking into account the intricacies of movement, biomechanics, and muscle interactions.


The Dynamic Nature of Shoulder Impingement:


Shoulder impingement is more than a static structural problem; it's a dynamic issue influenced by the way our shoulder functions during various movements. Understanding this dynamic perspective is vital for effective diagnosis and treatment.


Dynamic Movement Aspect:

Shoulder impingement varies with different movements, such as reaching overhead, rotating the arm, or even during daily activities. These movements can either aggravate or alleviate the symptoms associated with impingement.


Biomechanical and Kinematic Factors:

Factors such as muscle imbalances, altered scapular movement, and incorrect muscle firing patterns can contribute to the development of shoulder impingement. It's not solely about the space within the shoulder; it's about how muscles and bones work in harmony during motion.

The next section will delve into these factors contributing to shoulder impingement in more detail.


Factors Contributing to Shoulder Impingement:


To comprehend shoulder impingement from a dynamic perspective, we need to delve into the intricate factors that influence its development. It's a result of a complex interplay of muscle imbalances and movement patterns.


Muscle Imbalances and Their Role:

Muscle imbalances around the shoulder can disrupt the smooth movement of the joint. For instance, an overdeveloped chest and weak upper back muscles can cause the shoulders to roll forward, impacting the subacromial space and potentially leading to impingement.


Faulty Movement Patterns:

Incorrect movement patterns during activities like lifting, reaching, or carrying heavy loads can also contribute to shoulder impingement. These patterns often stem from poor posture, muscle imbalances, or inadequate muscle activation.

Understanding and addressing these contributing factors form the basis of a dynamic approach to managing shoulder impingement effectively.


Assessment and Diagnosis of the Shoulder Includes:


  • A traditional orthopedic examination of the shoulder

  • A quadrant examination evaluating related in nearby structures including the cervical spine, thoracic spine mobility, scapular stabilizing musculature and of course specific shoulder range of motion, mobility and strength.

  • Evaluating Muscle Activation and Coordination

  • Assessing how muscles activate and coordinate during movement helps in identifying imbalances and weaknesses.

  • Muscle activation patterns provide valuable information on whether certain muscles are overcompensating or underutilized during specific movements.


An accurate assessment lays the foundation for a tailored treatment plan addressing the individual needs of the patient, focusing on correcting movement patterns and enhancing muscle function.


Treatment Approaches:


A dynamic perspective on shoulder impingement warrants treatment approaches that encompass not only symptom alleviation but also a focus on correcting movement patterns and restoring optimal function of the shoulder complex.


Treatment Strategies:

  • Manual TherapyTechniques: Hands-on techniques to restore proper joint mechanics, mobility and muscle flexibility.

  • Functional Movement Training: Incorporation of movements relevant to daily activities to ensure a smooth transition from rehabilitation to real-life scenarios.

  • Scapular Strengthening: Targeted exercises to improve scapular stability and control, which is crucial for optimal shoulder function.

  • Rotator Cuff Strengthening: Strengthening exercises for the rotator cuff muscles to enhance stability and support for the shoulder joint.


A holistic approach involving these strategies aims not only to relieve pain but also to restore the shoulder's dynamic function.


Proactive Measures:

  • Regular Exercise Routine: Including thoracic spine mobility, scapular stability, posterior shoulder mobility and strength and functional movement with functional overhead activities.

  • Posture Awareness: Being mindful of posture during daily activities to prevent forward rolling of the shoulders, which can contribute to impingement over time.

  • Proper Lifting Techniques: Ensuring correct lifting and carrying techniques to avoid unnecessary strain on the shoulders.

  • Mobility Exercises: Engaging in exercises that enhance the range of motion of not only the shoulder but also the thoracic spine.


By making these measures a part of one's routine, individuals can significantly reduce the risk of developing shoulder impingement and maintain optimal shoulder function.


Conclusion:

Understanding shoulder impingement through a dynamic lens is crucial for effective management and prevention. It allows us to address not only the symptoms but also the underlying movement patterns and muscle imbalances. By adopting a holistic approach that emphasizes movement, muscle balance, and preventive measures, we can promote shoulder health and enhance overall quality of life.


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