Impingement Syndrome

• A curved or hooked acromion (type 2 or type 3) that affects the subacromial space (instead of a flat acromion (type 1) which does not).
• Repeated stress or overuse stemming from activities like overhead throwing, overhead exercise or work activities.
• Trauma, like falling on the shoulder.

Impingement Syndrome can be broken down into two basic classifications: primary impingement and secondary impingement.

• Primary impingement: The condition is inherent to the individual’s anatomy due to abnormal bio-mechanics in the shoulder. This predisposition in combination with primary factors may lead to narrowing of the subacromial space. Primary factors are usually congenital in nature manifesting usually later in life. An individual will begin to complain of anterior should and lateral arm pain combined with weakness in the shoulder. This pain will begin to become more frequent in occurrence and leads to difficulty completing overhead activities and preforming normal arm mobility.

• Secondary impingement: Occurs when one of the shoulder joints (gleno-humeral and/or scapula thoracic) experiences a decrease in stability. Secondary Impingement is more typically seen in younger individuals, specifically athletes, particularly those practicing sports characterized by overhead movements like baseball, volleyball, softball, swimming and tennis. Repetitive use of the arm without proper muscle rest can cause the posterior aspect of the shoulder to become agitated and tight. This limits the potential range of motion specifically having difficulty reaching across the body and behind the back.

Only a physician, physical therapist or other health care professional can properly diagnose Impingement Syndrome as it is important to rule out conditions that produce similar symptoms such as cervical spine defects or injuries.

• In cases of Secondary Impingement, pain will often be acute due to the sudden severity of the injury. For Primary Impingement, the condition will gradually become more noticeable, as the onset of pain is often gradual.
• Pain and/or achiness at the tip and front of the shoulder that can radiate down the lateral arm even when the arm is at rest.
• Pain with lifting, throwing, and reaching motions across the body. This may include a painful arc of motion between 60-120 degrees of motion during overhead activities.
• Difficulty sleeping on the afflicted side of the body and performing daily activities, such as dressing or combing your hair.
• Restricted range of motion of the shoulder limiting the ability to reach for items.
• Weakness with motions or resisted activities above 90 degrees of flexion or abduction (reaching overhead).
• Some individuals experience a grinding or popping sensation when attempting to flex the arm.