Suffering from shoulder pain during your lifts or just movement of the arms overhead. Don’t understand why this is happening or how to fix it? Have you been diagnosed with the term subacromial impingement, or feel as you suffer from this injury? If so, this post is written to help you!
What is subacromial impingement?
Subacromial impingement is a term used to describe a form of shoulder pain or injury. To first understand what subacromial impingement is we have to understand the anatomy of the shoulder. The shoulder is made up of the scapula better known as the shoulder blade as seen below. At the top of the scapula sits the acromion . The rotator cuff is a group of muscles which provides support and function to the arm allowing us to rotate and lift the arm. This group of muscles runs directly underneath the acromion of the scapula. During lifting of the arm the rotator cuff muscle group can rub against the acromion causing pain or a pinching feeling resulting in the term subacromial impingement.
What causes shoulder impingement?
Shoulder impingement can be caused from many different reasons, however the most frequent is overuse injury creating inflammation and swelling of the rotator cuff tendon creating the rubbing of the acromion. Another cause can be created by Scapula depression resulting in a lowering of the acromion resulting in less room for the rotator cuff tendon to pass through resulting in pain. Scapular depression can be diagnosed by one shoulder blade being lower than the other as seen below.
Who is at risk?
Subacromial impingiment is most commonly seen in those who have frequent overhead motions throughout the day, below is a brief list but is not all-inclusive
- Baseball players
- Tennis
- Swimming
- Volleyball players
- Jobs requiring frequent manual labor, and overhead motions.
How do I know if I have subacromial impingement ?
Subacromial impingement can be diagnosed by a Physical therapist or an orthopedic specialist. Signs that are present are pain with active and passive range of motion of the arm. Pain with internal rotation of the arm overhead as this narrows the space between the rotator cuff tendon and acromion, Shoulder weakness may also be present along with point tenderness on the outside of the shoulder.
How do I fix my subacromial impingement?
To correct the problem we must first identify the cause is it due to overuse, scapular depression, or muscle imbalances. Minimizing overhead motions allows us to rest the tendon and prevent further inflammation and damage. Our secondary goal should be to encourage improving lack of range motion that is present, this can be accomplished through soft tissue management of the pectoralis and latissumis doors muscle. Lastly is to build strength of the rotator cuff, leading to better shoulder stability, the serratus anterior to allow for better overhead stability, and the lower and middle trapezius muscle allowing for better positioning of the shoulder blade and correcting of any scapular depression.