Thursday, 1 October 2015

Painful arc of the shoulder – Impingement Syndrome


Our last article generated a lot of feedback, and we wanted to provide our reader with a better understanding of what happens when they have shoulder pain. Impingement Syndrome is an all too typical of a shoulder dysfunction. Our clinical teams are well aware of the pitfall of poor therapy or patient management. Therefore, when you get your shoulder pain treatment through our physiotherapy or chiropractic in Malaysia, you can rest assured that the care you get is of the best clinical teams in town. 

The glenohumeral joint is a relatively unstable ball-and-socket joint as the glenoid cavity is a shallow cavity. Static stabilizers of the joint include glenohumeral ligaments, glenoid labrum and capsule. Rotator cuff and scapular stabilizing muscles are the primary dynamic stabilizers of the shoulder. The impingement of rotator cuff tendons usually happen as they pass through the subacromial space formed between the acromion above and the glenohumeral joint below. Abnormalities of the structures around this region that compromise the subacromial space would cause irritation and damage to the tendons.

The acromion may be beaked, curved or hooked in shape due to a congenital abnormality or osteophyte formation. This may irritate the tendon from above due to the close proximity of both structures. Weakness of the scapular stabilizing muscles such as serratus anterior and excessive tightness of the pectoralis muscle would cause excessive angulation of the acromion. The acromion would move forward and downward into subacromial space. Muscle imbalance between humeral head elevators (deltoid) and stabilizers (rotator cuff muscles) results in excessive upward movement of the humeral head. This would further damage the tendons as the humeral head pushes them up against the undersurface of the acromion.

Swimmers and athletes with overhead activities such as throwing and overhead shots in racquet sports are prone to shoulder pain due to repetitive trauma to the rotator cuff. A painful arch of the shoulder while lifting up the arm at the side of the body between 70 degree and 120 degree is commonly seen. Difficulty combing the hair and reaching behind the back are common with impingement syndrome. The front and side of the shoulder may be painful upon palpation.

For more information or enquiries, please contact us at 03-20931000.

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