Impingement - Shoulder Pain

2023 Author: Wallace Forman | [email protected]. Last modified: 2023-11-27 18:19

Impingement of the shoulder: what is it?

The shoulder is the most flexible joint in the body, but it is exposed to a variety of disturbances. The shoulder bottleneck syndrome (impingement syndrome), for example, can have a wide variety of causes, including unusual extreme movements, overuse, torn tendons or muscular imbalances…

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Bottleneck in the shoulder

When the shoulder is impinged, the normally finely tuned system becomes unbalanced. There is a spatial constriction, so that the tendons of the rotator cuff (major muscle group of the shoulder), bursa and the underside of the shoulder roof meet. This results in excessive stress on the tendons and / or the bursa. Painful tendon irritations (tendinopathies) and inflammation of the tendons and / or the bursa, as well as restricted mobility can follow.

Significant for impingement is the occurrence of pain when the upper arm is raised to the side (spreading, abduction) between 60 and 120 degrees, ie slightly below and above shoulder level (“painful arc”). Pain can also arise when lifting the shoulder backwards or forwards. Typical painful everyday movements are overhead work such as cleaning up dishes, cleaning windows or putting on a jacket with arms stretched backwards.

Note Bottleneck syndromes of the shoulder are also known under the terms “impingement” or “subacromial” syndromes of the shoulder.

Causes of Impingement Syndrome

Due to the very complex structure of the shoulder and the involvement of different structures, there are many different reasons for the development of an impingement syndrome. Often there are also mixed forms of several factors that interact and flow into one another.

Possible causes of a bottleneck (impingement) of the shoulder include:

Changes in bones

The formation of a spur below the roof of the shoulder or other osseous adhesions such as a malfunctioning fracture can promote narrowing in the shoulder. However, misalignments of the spine such as a hunched back (kyphosis) lead to long-term changes in the biomechanics of the shoulder.

Changes in the size of the structures involved

Swellings or calcifications make the shoulder more narrow. Examples are the swelling of the bursa or the calcification of a tendon.

Muscular imbalances

Imbalances in the muscles in the shoulder girdle can interfere with the biomechanics of the shoulder. Insufficiently developed rotator cuff muscles (more under The Shoulder), but also excessive training can put the shoulder out of balance. Tendon irritations or tears can also be the result.

Overuse

In particular, certain (overhead) sports such as tennis or handball can cause excessive stress on the shoulder. In weight training, unilateral training of certain muscles can lead to changes in the position and mobility of the shoulder.