1.Impingement means that the Tendon that attaches the shoulder muscles to the arm is trapped between the end of your collarbone and the bone of your arm. Every time you try to reach for things above your head or you move your arm up above your shoulder, the tendon is squeezed between the bones, like a sandwich.
2.The tendon then becomes swollen and inflamed
3.If you do not get treatment the tendon can get worn out or torn.
4.Alterations in the way your shoulder blade is positioned can be a source of shoulder impingement when you elevate your arm
5. Once normal mechanics of the shoulder are achieved and patient is pain free, more advanced exercises are done to help make your muscles stronger and this will protect the tendon from being damaged.
A manuscript published in the Journal of Sports Physical Therapy in 2009 by Ludewig, P et al, evaluated scapular and clavicular abnormal kinematics in various shoulder pathologies and the management of these dysfunctions. The study found that in the presence of glenohumeral instability, impingement syndrome, and shoulder diseases such as adhesive capsulitis and post immobilization stiffness causes shifts in normal scapular mechanics. They found the altered scapular mechanics to be the result of muscular imbalance of scapular stabilizers, as well as impaired posture contributing to glenohumeral posterior capsule tightness and thoracic kyphosis. The authors concluded that in therapy of shoulder conditions the scapular mechanics must be assessed to properly carry out interventions and therapeutic exercise (Ludewig 2009).
This post was written by Peak Performance Physical Therapist, Christine O’Conell, Pt. She received her Doctorate degree in Physical Therapy from Touro College. In addition, she holds a Bachelor’s degree in Biology.