BIOMECHANICS

TOPIC – SHOULDER JOINT

IMPINGEMENT

PRESENTED TO -: PRESENTED BY -:
DR. RABAB KAUR AYUSH SINGH
SHIVANI KUMARI
(BPT V SEM SEC 1)
DEFINITION
Shoulder impingement is compression and mechanical abrasion of
supraspinatus as they pass beneath the coracoacromial arch during
elevation of the arm.
PAINFUL ARC SYNDROME
Pain in the shoulder and upper arm
during the midrange of glenohumeral
abduction with freedom
from pain at extremes of the range due
to supraspinatus damage.
SIGN AND SYMPTOMS
• Pain when your arms are extended above your head.
• Pain when lifting your arm, lowering your arm from a raised position or
when reaching.
• Pain and tenderness in the front of your shoulder.
• Pain that moves from the front of your shoulder to the side of your arm.
• Pain when lying on the affected side.
• Pain or achiness at night, which affects your ability to sleep.
• Pain when reaching behind your back, like reaching into a back pocket or
zipping up a zipper.
• Shoulder and/or arm weakness and stiffness.
CAUSES
• Your tendon is torn or swollen. This can be due to overuse from
repetitive activity of the shoulder, injury or from age-related wear
and tear.
• Your bursa is irritated and inflamed. Your bursa is the fluid-filled sac
between your tendon and the acromion. Your bursa helps your
muscles and tendons glide over your bones. Your bursa can become
inflamed due to overuse of the shoulder or injury.
• Your acromion is not flat (you were born this way) or you have
developed age-related bone spurs on your acromion.
STAGES OF SHOULDER
IMPINGEMENT
• STAGE I - Edema and Inflammation

• STAGE II - Fibrosis and Tendinitis

• STAGE III – Bone spur and Tendon rupture.

TYPES OF IMPINGEMENT
• PRIMARY IMPINGEMENT -: It is a direct result of compression of the
rotator cuff tendons between the humeral head and the overlying anterior
third of the acromion, coracoacromial ligament, coracoid, or acromial-
clavicular joint
• SECONDARY IMPINGEMENT -: Impingement or compressive
symptoms may be secondary to underlying instability of the glenohumeral
joint.
• INTERNAL IMPINGEMENT -: An additional type of impingement more
recently discussed as an etiology for rotator cuff pathology that can often
progress to an undersurface tear of the rotator cuff in the shoulder of a
young athletic patient is termed as Internal impingement.
DIAGNOSIS
• X-RAYS

• MRI

• ULTRASOUND

• USING ANESTHETIC (PAINKILLER)

• PHYSICAL EXAMINATION
TREATMENT GOALS

• To relieve pain and swelling.

• To decrease inflammation.
• To retard muscle atrophy and strengthen cuff muscle.
• To maintain and improve range of motion.
• To increase neuromuscular control.
• To increase strength and endurance.
• Unrestricted symptom free activities.
TREATMENT
• Cryotherapy
• Electrotherapy
• Biofeedback
• Manual Therapy
• Therapuetic Exercise
• Stretching
• Strengthening
• Taping
• Surgery
PREVENTION
• Smart training

• Watch posture

• Keep inflammation under control

• Move correctly
REFRENCES
• J Hodler
• Todd S. Ellenbecker
THANK YOU