“The Doctor Says That I Have a Shoulder Impingement…”
Were you recently diagnosed by your doctor with a shoulder impingement but have no idea what that means exactly? Unfortunately, it is a pretty common injury to the shoulder but it may be caused by a number of different factors. An impingement refers to a compromise of space that allows a tendon or bursa to get “pinched” as it glides or shifts within that space. The most common area for an impingement to occur in the shoulder is a space called the subacromial space.
As in the image below, the prominence on the top of the shoulder is called the acromion, which is part of the scapula, or shoulder blade. It is beneath this part of the shoulder blade that sits a bursa, which is a fluid-filled sac that acts as a cushion to some other structures. These other structures are the tendons of your rotator cuff, as well as the tendon of your bicep muscle. A tendon is what attaches the muscle to the bone, and the rotator cuff is made up of four small muscles deep within the shoulder. These muscles are responsible for stabilizing the shoulder with movement. In other words, when we move our arm overhead, the rotator cuff keeps the joint together and stable. It is a crucial complex that can easily become inflamed when the space around the tendons is compromised.
A couple of reasons why the subacromial space may be compromised are related to your posture. If you have a more rounded shoulder that means that the shoulder blade (acromion) are sitting more forward in the shoulder. That closes up the subacromial space and makes it easier to “pinch” the rotator cuff and bicep tendons. If you have lack of space because of poor posture, that increases the likelihood of irritation of the bursa or tendons in your shoulder. By “pinching” those structures, you are bringing inflammation to the area which further “fills up” the subacromial space.
The goal of a physical therapist would be to open up this space and stretch the muscles that are allowing the shoulder blade to sit forward as well as strengthen the muscles that would help to stabilize the shoulder blade in a more proper position.
Now you may find it easier to understand the doctor’s diagnosis of a shoulder impingement, but my recommendation is to seek more detailed guidance from your doctor and/or physical therapist. There are a variety of stretches and strengthening exercises that may benefit your shoulder, but it is wise to get an extensive evaluation as every shoulder is different!