Shoulder Impingement and Rolled Shoulders

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shoulder_impingement_intro01The shoulder joint consist of the shoulder blade, the humerus, and many muscles and ligaments. The key muscles are the rotator cuff (supraspinatous, infraspinatus, subscapularis, and teres minor), scapula stabilizers (serratus anterior and low-mid traps), and the pec muscles. When these muscles become imbalanced limitations and injury can persist.

Shoulder pain occurs in nearly ¼ of the general population and shoulder impingement is the most prevalent diagnosis in these cases. Shoulder impingement is also called supraspinatus syndrome, swimmer’s shoulder, and thrower’s shoulder and occurs when the tendons of the rotator cuff muscles become irritated and inflamed as they pass through the joint. The rotator cuff muscles become compressed during movement and the body has to adjust to perform movements.

Symptoms of shoulder impingement are pain with raising arm from the side, weakness in lifting the arm, and loss of range of motion in the shoulder joint. This occurs due to incorrect repetitive motion and faulty posture. These faulty movements and postures tend to cause overuse of the pec muscles, levator scapulae, upper trap, and some of the supraspinatus.  At the same time, weakness of the mid and lower trap occurs. These imbalance leads to increased faulty movement patterns of the shoulder and injury occurs.

 (Photo: erikdalton.com)
(Photo: erikdalton.com)

In today’s society, rolled shoulders or forward shoulders are occurring more and more. This occurs due to computer/desk jobs and the fact that we sit for most of our day.

Commonly when the shoulder rolls forward the pec, upper trap and levator scap muscles become overactive. As a result the shoulder blade elevates and the arm rotates inward. This position places the shoulder stabilizers in a long, weak position. When imbalances occur in these muscles stability is lost and the chance of injury greatly increases.

As the imbalances and faulty posture continues, increased stress is placed on the shoulder, especially the supraspinatus. Due to the rolling and shoulder blade position the space the supraspinatus tendon runs through is lost and the tendon becomes impinged. Over time this compression leads to irritation and inflammation and pain follows.

Treatment for shoulder impingement consist of stretching, Active Release and/or Graston, and functional rehabilitation of the shoulder blade stabilizers, thoracic spine, and rotator cuff muscles. So if you are dealing with shoulder pain see this weeks exercises by clicking here.

Yours in Health,

Dr. Justin Hildebrand

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