I have gotten this from several athletes that come in to train and are coming off of a season of playing sports (mostly baseball and football) that often complain of this problem. So I thought I would make a quick post on the subject.
Shoulder impingement is one of the leading causes of chronic shoulder pain in athletes and adults who perform constant or repetitive movements involving raising the arm at shoulder height or above. It is not that uncommon; I had shoulder pain in college when playing football, and if I don’t take care of my shoulder, all of the old pains come rushing back even after all these years.
The rotator cuff is a tendon linking four muscles: the supraspinatus, the infraspinatus, the subscapularis, and the teres minor. These muscles cover the "ball" of the shoulder (head of the humerus). The muscles work together to lift and rotate the shoulder.
The acromion is the front edge of the shoulder blade. It sits over and in front of the humeral head. As the arm is lifted, the acromion rubs, or "impinges" on the structures within the subacromial space, a limited space found between the head of the humerus and the acromion, the curved bony prominence from the top of the shoulder blade. The structures most commonly involved in shoulder impingement are the supraspinatus tendon of the rotator cuff, subacromial bursa and the long biceps tendon.
By building stronger shoulders, the signs and symptoms caused by shoulder impingement will be eliminated. To understand how shoulder impingement is caused, it is essential to start with the basic anatomy of the shoulder joint complex.
The Shoulder?
The shoulder has the largest range of motion of any joint in the human body. It is especially designed to allow great degrees of mobility without difficulty and pain. However, because of its ability to move in a wide plane of motions, the shoulder is the least stable joint in the body, making it highly susceptible to injuries during overhead and rotational arm movements. (one of the reasons I am NOT a fan of overhead lifting with any type of overhead athlete like a pitcher, swimmer or QB)
Each shoulder girdle is formed by a clavicle (collarbone) and a scapula (shoulder blade). The clavicle attaches to the breastbone to form the sternoclavicular joint, whereas the head of the humerus attaches to the scapula’s shallow socket called the glenoid fossa to form the glenohumeral joint, the major shoulder joint.
The rotator cuff muscles, consisting of the supraspinatus, infraspinatus, teres minor and subscapularis, fuse together and form a cuff or band surrounding the top of the humerus to hold it securely in place and to lift rotate the shoulder. Without an intact rotator cuff, the head of the humerus would move excessively off the center of the glenoid fossa, possibly resulting in impingement.
The subacromial space is frequently involved in shoulder impingement. Located below the acromion process and above the humeral head, the subacromial space contains the tendons of the rotator cuff, the long heads of the biceps and the subacromial bursa.
The bursae function as the gliding forces that reduce friction between tendons and bones. In a relaxed and neutral position, the size of the space is fairly wide; however, on arm elevation and inward rotation, the space narrows, consequently pinching on the structures within the subcromial space. To protect the structures from the squeezing effect, the subacromial bursa reduces the pressure.
If the impingement becomes too repetitive or too forceful, the involved structures are injured, leading to shoulder pain, weakness and reduced range of motion.
If you’re having problems I would suggest you speak with your sport coach or contact your doctor to refer you to a qualified specialist to address this problem.
Brian Van Hook MS, CSCS
Strength Training in Las Vegas
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