Shoulder pain is one of the most common complaints we address at MOTUS. We see it on a regular basis and in sports specific contexts, where athletes use their shoulders excessively for motions like throwing, swinging, and serving. By using an individual’s personal history and a physical examination, we can determine what’s causing the shoulder pain and how to treat it. In many cases, the diagnosis is shoulder impingement, or subacromial impingement.

The shoulder’s design is unique in several ways. One thing that sets it apart is how instead of muscle surrounding bones, it has bones around its muscles. The rotator cuff, bicep tendon, and other soft tissues are situated between the ball and socket joint and the acromion, the highest part of the scapula. This area is called the subacromial space.

Whenever you raise your arm, the subacromial space becomes smaller as these bones move towards one another. With a subacromial impingement, this motion pinches the soft tissues in the subacromial space, causing pain and other symptoms.

An impingement diagnosis describes the mechanism of injury within the diagnosis. It’s more of a syndrome — a group of symptoms and signs pointing to a problem — than it is a condition. There’s something causing the impingement to occur, and that is the problematic condition we need to treat.

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Sometimes impingement is caused by overuse. When an athlete puts regular demands on their biceps and rotator cuff without taking proper rest and care in between performances, the soft tissues can become irritated. This leads to swelling and inflammation, which takes up more room in the subacromial space.

Weakness, instability, and imbalance in the shoulder muscles can also lead to impingement. Without proper training and technique, athletes could potentially move in a way that causes friction and pinching in their shoulder.

Symptoms from impingement usually come on gradually. You might be able to feel a pinching sensation in the shoulder when you do certain overhead movements, like throwing or just reaching the arm up high. Pain could get worse when you lay on the side with impingement. Impingement also tends to affect range of motion and strength.

When we treat impingement, we start with the underlying issue. Whether or not your shoulder impingement is due to overuse, our first step will be limiting your overhead activity. We want to give the soft tissues a chance to recover. Then we can move forward with therapeutic exercises designed to correct your posture and technique, and to strengthen your shoulder muscles. Gradually we will restore the function of your shoulder, and teach you maintenance exercises that will help keep your muscles balanced and protect you from re-injury.


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