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Sub Acromial Impingement

MTM > Sub Acromial Impingement

Anatomy:

  • The shoulder is a ball and socket joint, made of the glenoid of the scapula and the head of the humerus
  • The joint is held in place by the rotator cuff which is made of:
  1. Supraspinatus
  2. Infraspinatus
  3. Teres Minor
  4. Subscapularis
  • The rotator cuff gives dynamic stability through the large degree of rotator cuff range of motion. In other words, the rotator cuff keeps the shoulder in place whilst still allowing a large amount of movement.

Pathology:

  • Impingement occurs when there is inflammation of the rotator cuff tendon(s) causing irritation in the subacromial space
  • Sometimes impingement can occur when the acromion of the scapula overhangs the joint space too much, this is caused a bony impingement
  • Commonly a painful arc is present (pain when lifting your arm above your head forward or sideways at around 90 degrees)
  • This generally occurs due to
  1. Repeated overhead activity
  2. Swimming
  3. Throwing
  4. Basketball shooting
  5. Previous tear
  6. Poor posture

Treatment can include any of the following:

  • Soft tissue release the muscles around the shoulder and upper back to improve range of motion in the shoulder and thoracic spine
  • In the initial phase of your rehab, it might be recommended to you to ice your shoulder or take some Anti Inflammatories to reduce the level of inflammation within the sub acromial space
  • Home stretching program- given to you by your Physiotherapist
  • Your physiotherapist will guide you through a series of Scapula and Rotator cuff stabilising then strengthening exercises for you to do at home
  • At end stage rehab your Physiotherapist may recommend pilates or gym based rehabilitation. This is dependent on your level of activity and what you primarily use your shoulder for.