Shoulder Impingement

What is shoulder impingement?

Shoulder impingement is a common affliction, especially among overhead athletes and workers, caused by poor tracking of the head of the humerus bone under the bony roof of the shoulder (acromion). In a normally functioning shoulder, the head of the humerus spins smoothly in the socket avoiding contact with the structures forming the top of the shoulder joint. If the humeral head glides upwards as a person reaches into end-ranges of motion (especially overhead), the humerus may impinge on the acromion, pinching the soft tissues (rotator cuff and bursa) between the bony structures causing pain and limited motion.



How do people get shoulder impingement?

There are two general reasons people experience impingement: primary and secondary. Primary impingement is uncontrollable and related to anatomical factors that adversely affect the interface between the humeral head and the socket. The most common of these are a hooked acromion which means the bone forming the roof of the shoulder joint offers less space than normal, or degenerative changes in the acromioclavicular joint or shoulder joint causing bone spurs to decrease the space between the humeral head and the roof of the joint. Secondary impingement occurs when muscle and capsular imbalances exist and alter the coordination of movements into end-ranges. If the muscles are not working well together, the head of the humerus will not glide underneath the acromion (roof of the shoulder joint) and will impinge, causing pain referral into the upper arm.



How can I avoid shoulder impingement syndrome?


Primary impingement is not a controllable factor and avoidance of impingement symptoms requires staying out of end-ranges that will create impingement. People having these predisposing factors will not do well as swimmers or in throwing sports. Secondary impingement can be avoided by maintaining good posture and muscle balance across the shoulder joint. The maintenance of good posture and the strength of the rotator cuff muscles is particularly essential for people who consistently work or move into the end-ranges of motion overhead. The exercises described below for rehabilitating shoulder impingement syndrome also serve as good exercises for prevention in swimmers and throwing athletes.



How can I deal with shoulder impingement?



If you have shoulder impingement syndrome, the soft tissues that have been pinched consistently are likely rather inflamed and irritated. The initial phase of rehab involves calming the local inflammation with ice, anti-inflammatory medications, rest, postural corrections and pain-free motion. Proper posture puts the shoulder in a neutral position, which increases the space between the humeral head and the acromion and puts the muscles into better positions to work appropriately. Avoidance of reaching into end-ranges overhead is suggested during this time, allowing the tissues to heal. The next phase of rehabilitation builds on the initial postural adjustments adopted during the calm-down phase. The goal during this phase is to progressively regain shoulder motion while avoiding the range of impingement and to rebalance muscle forces across the shoulder.


Please contact Walton Physical Therapy to schedule an injury evaluation and discuss possible treatment options you might need.





http://www.waltonpt.com/

What is Core Training?

Core training is essential to training for athletes as well as fitness enthusiasts. The core has been called the "power zone" and "power house" where the body's center of gravity is located. Most of all it is where all movements are initiated.

The muscles of the core include the abdominals, muscles of the hip and back. They are located at the core of your body where the limbs extend from. These muscles are responsible for developing power, maintaining balance and stability and improving coordination.

Just imagine performing a golf swing or even carrying groceries and how important it is to use your core to perform these movements. The benefits of a strong and stable core include:

• Increased power development to help with those movements that require changing direction, accelerating the body or limbs, etc.


• Improved stability and efficiency to be successful of providing an anchor for the major muscles of the upper and lower body.


• Improved balance to enhance athletic, recreational and daily living activities.


• Reduce risk of injury

Core training can be easily implemented into an existing strength routine by doing the following:

• Perform exercises standing on one leg or unstable surfaces


• Change seated exercises to standing exercises


• Make controlled movements in different planes of movement - rotate, diagonal, etc.


• Have feet together rather than apart when standing or sitting on a exercise ball


• Perform the exercises at different speeds

Hints to remember:

• Always control the movement performing


• Focus on what muscle or muscle group (s) using during the exercise and FEEL them working


• Read your body


• Maintain your posture

Go get'em. There are a lot of fun ways to train your core. Enjoy!!!!!

Resource: NSCA's Performance Training Journal, Volume 2, number 6.