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Shoulder Impingement Syndrome

Please read 'how the shoulder works' before you read the following.Pain at the top and/or outer edge of the shoulder that normally comes on gradually, often after increasing training, modifying the position of training or training when tired in sports like swimming, tennis, martial arts and weightlifting.

This is often painful through the middle of the range of movement as you take your arm out to the side and then up to above your head. Try this test – stop as soon as you feel pain: stand with your arms out in front of you as if you are hugging a large bear (!) and holding two pints of water in your hands! Now twist your arms so that you pour the imaginary water on the floor. If it hurts this is one of the signs of impingement.

Impingement means that soft tissues are being squashed or irritated in a confined space at the top of the shoulder. Many different things can cause impingement. It can be either something “extra” in the space, such as thickened, torn or inflamed tendons, inflamed bursa, or something closing up the space available, such as arthritis in the joint, cartilage tears or abnormal bone shape, or even altered shoulder posture. Inflammation causing pain prevents the muscles from working correctly and the swelling further reduces the space available causing more restriction and pain.

Treatment: Treatment consists of correcting shoulder position to take strain off the inflamed structures, retraining the stabilizing muscles of the shoulder blade, strengthening the rotator cuff muscles and releasing tight muscles like the pecs and lats.The thoracic spine (mid back) may also need mobilizing because this needs to be moving well to enable full shoulder movement, and is often stiff.The gluts and core muscles may also be strengthened as part of treatment. These large muscle groups may seem a fair distance from the shoulders, but they have a huge effect on the ability of the shoulder muscles to function efficiently, particularly if you are returning to repetitive lifting or sports like tennis or swimming.Please click on this link to learn how to train shoulder posture which enables the shoulder to function efficiently without excess strain going through the joint and surrounding tissues.Please click on this link to learn how to train your shoulder blade stabilizers which enable you to put your shoulder in the correct posture.

Please click on this link to learn how to train the serratus anterior muscle that is often weak with shoulder impingement.

Please click on this link to learn how to stretch the lats (latissimus dorsi)muscles which are often tight and overactive.

Please click on this link to learn how to mobilise a stiff thoracic spine.

Please click on this link to learn how to train the rotator cuff muscles that are often weak.

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