Have you ever experienced shoulder pain in your lifetime? Shoulder pain is one of the more common issues found in medicine, affecting about a third of the population at any given time in the life span (Chris Littlewood, 2013). While multiple issues could cause shoulder pain this article will home in on one of these issues, namely shoulder impingement. Shoulder impingement is common and involves the compression and irritation of the subacromial bursa, rotator cuff tendons, and/or the biceps tendon under the acromion as the arm raises overhead. One hallmark symptom includes pain painful range of motion commonly called a “painful arc” in which pain is felt at any point in the range while lifting the arm overhead. This is likely due to injury to the rotator cuff and surrounding structures.
So, what is the rotator cuff? The rotator cuff is a group of muscles responsible for the stability and mobility of the shoulder joint and consists of 5 muscles. These muscles include the supraspinatus, infraspinatus, the teres minor, teres major, and the subscapularis muscles (figure 1). Shoulder impingement can affect 2-21% of the population at any given point throughout the life span. One reason for this wide range of the population is because rotator cuff issues can happen for various reasons in younger and older populations, however the prevalence is higher in the older populations (Christina Garving, 2017).
For younger populations aged 30-60years old, shoulder impingement is more likely a cause of shoulder pain (Christina Garving, 2017). There are multiple causes for shoulder impingement, including anatomical defects of the acromion or even scapular dyskinesia. Shoulder impingement is also associated with a more forward position of the shoulder blade (called protracted) and poor posture (Andreas Christos Panagiotopoulos, 2019). For those older than 60 years old poor healing potential and the accumulation of micro trauma through repetitive use can become larger muscle tears in the rotator cuff. In some cases pain may not even be felt until the tear happens (CH Linaker, 2015).
There are multiple treatments available for rotator cuff pathologies, however research consistently points to physiotherapy and therapeutic exercise as a more cost-effective treatment for rotator cuff injuries. It has also been shown to reduce the number of surgeries performed on the shoulder due to this condition (Ingrid Hultenheim Klintberg, 2015). Don’t ignore pain! If you or loved ones are experiencing any symptoms listed in this article reach out to your physiotherapist or primary physician for an assessment.
Andreas Christos Panagiotopoulos, I. M. (2019). Scapular dyskinesia, the forgotten culprit of shoulder pain and how to rehabilitate. SICOT-J, 5(29), 1-6.
CH Linaker, K. W.-B. (2015). Shoulder disorders and occupation. Best Pract Res Clin Rheumatol, 29(3), 405-423.
Chris Littlewood, S. M. (2013). Epidemiology of rotator cuff tendinopathy: a systematic revidw. Shoulder & Elbow, 5(1758-5732), 256-265.
Christina Garving, S. J. (2017). Impingement syndrome of the shoulder. Deutesches Arzteblatt International(114), 765-776.
Ingrid Hultenheim Klintberg, A. M.-C. (2015). Consensus for physiotherapy for shoulder pain. International Orthopaedics, 39(4), 715-720. Retrieved from Linkoping University Post Print.