3 COMMON CAUSES OF SHOULDER PAIN
Before diving into treatment recommendations, let’s review 3 common shoulder categories.
#1 Impingement
Arguably the most common shoulder presentation in the clinic, research shows that shoulder impingement syndrome is believed to account for 44-65% of all shoulder complaints. 4 Shoulder impingement occurs as a result of the structural narrowing of the subacromial space causing the tendons of the rotator cuff muscle to become irritated and inflamed as they pass through the subacromial space of the shoulder joint. 10 This can lead to rotator cuff tendinitis with pain and limited range of motion in the shoulder. Symptoms of shoulder impingements can be similar to rotator cuff tears and should be thoroughly evaluated before prescribing a plan of care. Shoulder impingements are typically diagnosed by physical examination.
Common causes of shoulder impingement include
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Overuse or repetitive overhead movements, such as throwing, swimming, or painting. Improper scapular mobility and/ or muscle imbalances make impingement common in athletes and individuals with physically demanding occupations where repetitive overhead motions are common. Bone spurs in the shoulder joint that narrow the subacromial space. A recent study showed that 68% of adults in their late 50’s, with or without cuff tears, had acromial spurs and the incidence increased with age. 11 It also highlighted that individuals with spurs were more at risk for full thickness cuff tears.
Poor posture can contribute to poor scapular mechanics and anterior soft tissue restrictions that predispose individuals for shoulder impingement. This is a common driver for individuals that have desk jobs, especially with prolonged keyboard use.
Muscle weakness, poor endurance, or strength
imbalances at the rotator cuff and/or scapular muscles can lead to poor positioning of the glenohumeral joint under load or with overhead activities. This can lead to irritation of multiple tissues that reside below the acromion.
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SHOULDER IMPINGEMENT SYMPTOMS • Pain in the top and outer side of the shoulder 12 • Point tenderness over the distal attachments of infra and supraspinatus muscles • Discomfort with overhead movement 12 • Aching or pain in the night that impacts sleep 12 • Arm weakness 12
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Trauma or injury to the shoulder, such as a fall or sudden impact.
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