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Common Shoulder Conditions - Subacromial Impingement Syndrome

Common Shoulder Conditions - Subacromial Impingement Syndrome

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Published by Luke Van Every
Shoulder Impingement is the most common shoulder diagnosis. Learn about the causes, signs and symptoms and why you should seek expert shoulder physiotherapy to treat it.
Shoulder Impingement is the most common shoulder diagnosis. Learn about the causes, signs and symptoms and why you should seek expert shoulder physiotherapy to treat it.

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Published by: Luke Van Every on Mar 08, 2013
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05/13/2013

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March 8th, 2013Published by:theshoulderguy1
Common Signs and Symptomsof Subacromial Impingement
Source:http://www.theshoulderguy.com/common-shoulder-conditions/common-signs-and-symptoms-of-subacromial-impingement/By Luke Van Every on March 3rd, 2013
Considered the most common type of shoulder pain amongadults, subacromial impingement syndrome affects shouldermovement and reduced quality of life if not properly diagnosedand treated. Other parts of the shoulder such as the rotatorcuff may also present pain when injured or torn, making itnecessary for a clear identification of the patient’s symptomsprior to the creation of a management and treatment plan.Signs and SymptomsThe abrasive action of the surface under the acromion againstthe soft tissues located between the acromion and the humeralhead of the shoulder can lead to the following symptoms of subacromial impingement syndrome.Shoulder pain: Pain can occur when the shoulder is movedduring an overhead motion. The sensation of pain can increase when the arm is elevated.Tenderness: The affected area can feel tender usually at night when sleeping on the affected shoulder or with the arm abovethe affected shoulder.Limited range of motion: Pain and inflammation can affectshoulder mobility, limiting its usual range of motion.Oedema: Excess fluid can accumulate at the point of impingement and may be accompanied by warmth at theaffected area.3 Stages of Subacromial Impingement SyndromeStage 1: Often seen in young adults under the age of 25,impingement is characterised by oedema and haemorrhage inthe tendon area. Surgery may not be required.Stage 2: This stage of impingement involves tendinitis at therotator cuff which may require invasive procedures such as bursectomy and coracoacromial ligament division, often seenin patients between the age of 25 and 40 years old.Stage 3: Impingement is associated with bone spurs and aruptured tendon often manifested in patients over 40 yearsold. Anterior acromioplasty which aims to surgically remove aportion of the acromion to create more space for the movementof the rotator cuff may be required.Certain risk factors may increase the chances of impingement:
repetitive overhead throwing activities done by athletes
occupations that perform repetitive elevated shoulderpostures such as painting, welding and carpentry 
competitive swim training, i.e. freestyle and butterfly strokes
hook shaped acromionExamination of the patient’s history and physical conditionis important and this includes documenting properly thepatient’s symptoms as constant or intermittent, sharp or dull,aching or burning, and numb or tingling. The patient must also be examined for any presence of neck pain and pain radiatingto the arm. A patient’s pattern of symptoms from day throughnight must be recorded, including changes in symptoms.Other symptoms such as dizziness and sudden swellingof upper extremities may require referral to appropriatespecialists.
Understanding the Causesof Subacromial ImpingementSyndrome
Source:http://www.theshoulderguy.com/common-shoulder-conditions/understanding-the-causes-of-subacromial-impingement-syndrome/By Luke Van Every on March 6th, 2013
 Your shoulder is made up of bones and joints thatare connected together by several ligaments, tendons andmuscles. With the support of these soft tissue structures, theshoulder is able to function with a wider range of motion thanany other joint in the body.The shoulder functions to predominantly support the hand in various movements that allow it to perform both high poweredactivities, such as throwing, and to perform other complextasks that require more dexterity.Often, however, adults experience shoulder pain relatedto stress loading and inflammation of structures identifiedas subacromial impingement (pain) syndrome which limitsthe affected shoulder’s range of motion and functionalabilities. Due to the complex system controlling shoulder jointmovements, a clear determination of the etiology or cause orset of causes of subacromial shoulder pain is essential for any treatment plan to be effective.Possible causes of Subacromial Impingement Pain SyndromePosterior shoulder tightness: Overuse or overloading of theshoulder may cause tightness and restriction of the rotator cuff muscles and posterior capsule of the shoulder joint. This cancause the humeral head (ball) to shift upwards and potentially impinge during movements above shoulder height.Poor shoulder blade mechanics: For proper pain free functionthe shoulder complex is reliant on co-ordinated movements both of the arm and the shoulder blade. Abnormal shoulder blade postures, muscle activation patterns and timing have been shown to affect shoulder blade function and contributeto many shoulder pain states.Shoulder instability: An inability to stabilise the shoulder joint possibly due to inherent joint laxity or inhibition of key stabilising muscles through pain or fatigue may lead tosuperior migration of the humeral head and impingement of the rotator cuff tendons and bursa.Rotator cuff tendinopathy: When the rotator cuff is injured or becomes inflamed possibly due to an unaccustomed loadingepisode or change in training volume or speed, the swollen

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