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Shoulder Impingement

Right Shoulder Anatomy

This week, Chris explains the how shoulder impingement occurs, how it can effect your daily activities, and ways it can be treated.

Impingement of the shoulder is a common form of shoulder pain.

Shoulder impingement can be classified as:

  1. External Impingement: also known as sub-acromial impingement

  2. Internal Impingement

External impingement:

In external impingement, structures that live beneath the acromion become compressed between both the acromion and the humeral head (arm bone). This compression will often result in pain and a lack of strength in the arm. The main causes for this type of presentation include:

  • Anatomical causes: these are changes in the structures within the shoulder, such as bony growths on the acromion and/or degeneration.

  • Functional causes: this presentation is usually due to poor activation of the muscles, namely the rotator cuff muscles that stabilise the humeral head on the socket. When these muscles don’t work correctly the humeral head can slide up causing this impingement pattern.


Internal Impingement:

Internal impingement refers to the type of impingement that results from the compression of soft tissues such as the rotator cuff muscle, joint capsule and/or cartilage within the shoulder joint. This will occur between the humeral head and the glenoid (socket of the shoulder joint).

This type of impingement is commonly seen within the young, athletic population group and particularly in those that participate in throwing based sports.

Internal impingement will occur naturally with the throwing motion and in itself doesn’t necessarily cause pain however when this motion is repeated, this can cause repetitive trauma to the rotator cuff muscles and/or the cartilage surrounding the socket of the shoulder (the labrum).

Both forms of Impingement can effect an individual’s participation in their daily activities and sport. It is important that a professional such as a Physiotherapist correctly assesses the shoulder pain, so that diagnosis of the cause is accurate.

The management of this group of conditions can include the use of medications to assist with pain relief and inflammation and exercise rehabilitation. In some cases other interventions such as injections and surgery may be required if significant structural issues exist.

Chris Tandy
Senior Physiotherapist


If you have any questions regarding this post, or wish to book in to see our Senior Physiotherapists, please call us on 1300 858 774 or email contact@recoversportsmed.com.au

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