Shoulder Impingement Syndrome

Impingement syndrome is usually caused by the irritation and inflammation of the muscle and tendons of the rotator cuff (Supraspinatus, Infraspinatus, Teres minor and Subscapularis). As they pass under the acromion and through a narrow bony space called the subacromial space, the tendons rub along the bone causing impingement. Over time, this can lead to a thickening of the tendon(s), which can decrease the space in which the tendon travels, further impinging the tendon. 

Mechanism of Injury

• Acromion abnormalities
• Degenerative changes of the acromial arch with age 
• Poor scapular (shoulder blade) stabilization due to weak serratus anterior and tight pectoralis muscles. (Poor stabilization can alter the physical position of the acromion)
• Shoulder hypermobility

Treatment

• Manual Therapy to the shoulder joint
  
• Joint Mobilizations to shoulder
  
• Posture/Body Mechanics
  
• Therapeutic Exercise focusing on scapular stabilization, pectoralis length, and posture.
  
• Ultrasound
  
• Heat/Ice
  
• Electric Muscle Stimulation
  
• Home Exercise Program 

Anatomy