Shoulder Impingement

2588 WordsMar 29, 200511 Pages
The shoulder is the most complex joint in the body. It is capable of moving in more than 16,000 positions. Many of its ailments, including the most common ones, involve biomechanical mechanisms that are unique to the shoulder. The most common shoulder problem for which professional help is sought out for is shoulder impingement (Haig 1996). Shoulder impingement is primarily an overuse injury that involves a mechanical compression of the supraspinatus tendon, subacromial bursa, and the long head of the biceps tendon, all of which are located under the coracoacromial arch (Prentice 2001). Impingement has been described as a continuum during which repetitive compression eventually leads to irritation and inflammation that progresses to…show more content…
Evidence indicates that there is a natural age-related degeneration of the rotator cuff tendons. Rotator cuff tendon ruptures in older patients normally occur bilaterally and in the presence of preexisting tendon degeneration. The result of rotator cuff tendon degeneration puts the elderly population at a greater risk for developing type III shoulder impingement. An abnormally shaped acromion will also cause impingement on the cuff tendons. Three types of acromions have been identified. They are: type I (flat), type II (curved), and type III (hooked). In a study performed by Morrison and Bigliani, 70% of rotator cuff tears were associated with type II and III acromions. None had type I. Although the causal relationship between the shape of the acromion and rotator cuff tears or impingement can be concluded, the clinical findings support Neer's theory of impingement occurring primarily along the anterioinferior acromion (Donatelli 2004). Haig (1996) describes shoulder impingement as producing an atrophic, "worn away" appearance of the cuff tendons, which are frequently retracted. As compared to many joints in the body, rehabilitation of the shoulder is extremely important to the successful management of return to normal function for the entire upper extremity. It is probably the most difficult joint in the body to rehabilitate because of its great range of motion and the complex interaction of muscle
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