Shoulder Impingement 101

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Shoulder impingement syndrome is a diagnosis treated by physical therapists. This is a broad diagnosis, but most commonly the underlying issue is increased pressure or “impingement” of the structures that sit between the acromion and the humerus in the shoulder joint (See Image 1). The two structures most commonly affected are the subacromial bursa and the supraspinatus tendon. The good news is that this condition is preventable. We have outlined a few tips and tricks below to help you optimize your shoulder health. Creating a balanced environment for the shoulder: Often times, shoulder impingement occurs due to an imbalance of muscle length and/or strength in the body. For example, many individuals who work at a desk develop shortened muscles in the front of the shoulders and chest. In addition, the muscles surrounding in the back and surrounding the shoulderblades can become lengthened and weak. This is often referred to as “upper crossed syndrome”. (See Image 2) Some simple ways to combat these problems are to regularly stretch your pectoralis (chest) muscles and perform back and shoulder strengthening exercises, such as upright rows. Training considerations: As a general rule when strength training for the upper body, you should be pushing as much as you are pulling. For example, if you perform pull ups and rows as part of your workout also include pushing elements such as push ups or tricep dips. Research shows that it takes at least 6 weeks for hypertrophy to occur with dedicated strength training, so keep this principle in mind before you ask your shoulder to perform 100 overhead squats or play in a 3 day tennis tournament. Don’t forget about spinal mobility: Shoulder impingement is often not solely due to dysfunction in the shoulder. It is important to consider that the thoracic spine (mid-back) is also involved in overhead movements. Maintaining mobility in your thoracic spine can be achieved by performing exercises like extension over a foam roller (See Image 3). Functional mobility in this region is important to your shoulder health, and posture. If you would like more information or an assessment check out our website

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Noal Cattone