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Shoulder Pain? Shoulder Impingement Could Be the Problem

Shoulder Impingement

Do you have a nagging pain in the front or top of the shoulder with overhead motion? Most likely there is some impingement in your shoulder. Shoulder impingement, also known as subacromial impingement, typically happens over time. Most frequently, pain will occur in the front or top of the shoulder when reaching your arm overhead. The structures commonly involved are the subacromial bursa, biceps tendon, and supraspinatus. These structures can become inflamed and push against a bone in the shoulder called the acromion causing a sharp or pinching pain.

To further explain, first we need to understand scapulothoracic rhythm. The shoulder girdle actually consists of 2 joints.

  • The first is the glenohumeral joint (GH), commonly known as the “ball-and-socket”, which is typically the joint we think of when we refer to the shoulder.
  • The second is the scapulothoracic joint (ST), which isn’t a true bone-to-bone joint, but consists of the shoulder blade and its muscular attachments against the back.  

The first 30 degrees of overhead motion come strictly from the GH joint. Once you’ve hit 30 degrees, the ST joint begins to kick in and will rotate upward with the GH joint. For every 2 degrees the GH joint moves into overhead motion, the ST joint will rotate 1 degree upward.

Shoulder impingement often occurs with poor scapulohumeral rhythm. Muscle imbalances, including weakness in the upward scapular rotators and tightness in the downward scapular rotators, will contribute to your pain. These weaknesses often occur due to repeated poor shoulder biomechanics with overhead motion or poor postural strength and awareness.

Muscles to focus on strengthening include the lower trapezius, middle trapezius, serratus anterior, and rotator cuff musculature. Muscles to consider stretching include the levator scapulae, rhomboids, and pectoralis minor.

Contact Exchange Physical Therapy Group or visit us at our Hoboken, Weehawken, or Jersey City locations for an assessment to address these muscle imbalances. Follow @eptg_jc for to see a few exercises we can do to address your pain!


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