Impingement syndrome

The Rotator Cuff muscles are susceptible to cumulative/overuse injury. One of the leading causes of cumulative injury is poor posture and muscular imbalances which disrupt the normal biomechanics of the shoulder leading to alteration in the position of the humerus within the shoulder blade during arm movements.

The main rotator cuff muscle which is susceptible to this cumulative type of injury is the Supraspinatus which is located in the upper aspect of the shoulder blade within the Supraspinatus fossa

The Supraspinatus muscle passes between the collar bone and the head of the humerus. If the humerus is in an elevated position during arm movements, the tendon can become impinged or trapped between the head of the humerus and the underlying collarbone. This is often referred to as an impingement syndrome.

Apart from faulty biomechanics, there may also be other anatomical factors which can contribute to the development of an Impingement Syndrome by compromising the space of the bony supraspinatus outlet i.e. anterior acromial spurs and alterations in the shape of the acromion

Irrespective of the cause of impingement, overtime repetitive arm movements can lead to increased stress placed on the underlying tendons and the development of a tendinopathy/tear and in some cases a Subacromial bursitis.

Treatment of Impingement Disorders

At our city of London based chiropractic and Sports Injuries Clinic, our treatment approach is based on initially reducing any inflammation and accompanying pain from localised muscle guarding and tendon involvement. Once these symptoms have settled, most of the chiropractic treatment will be focused on improving the mobility of the shoulder through massage, manipulation and/or mobilisation of the shoulder, mid back and neck. It is also important for our EC2 chiropractors to improve the scapulohumeral rhythm and increase the space of the supraspinatus outlet through postural exercises. Specific scapula stability exercises will also be prescribed to help improve the biomechanics of the shoulder girdle thus helping to reduce further impingement and abnormal motion

If surgery is necessary, patients will be referred to an orthopaedic consultant and the surgical intervention of choice is usually an Arthroscopic Subacromial Decompression (ASD). The following animation describes this procedure:

http://www.shoulderdoc.co.uk/article.asp?article=1271&section=11

 If you would like any further advice regarding Impingement Syndrome, please contact us at our EC2 chiropractic clinic