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Impingement (clamping in the shoulder)

Why do you get impingement?


Muscular imbalance: This can be due to an imbalance in a muscle set called the rotator cuff. Its task is to ensure that the upper arm stays centered in the shoulder joint. If the coordination and strength between these four muscles is not optimal, then there can be a squeezing under one leg from the shoulder blade called acromion. This can occur during repetitive work with the arm in front of the body, for example during a lot of painting or during cash work in a store. It can also occur in various sports such as tennis, swimming and strength training.

Trauma to the shoulder: You can also, for example in a case where you receive with your arm, happen to press these tendons against the acromion, whereby an injury and thickening occurs in one or a couple of the tendons of the rotator cuff. Even the mucosa in the area, the subacromial bursa can swell. It then becomes crowded under the acromion when you lift the arm and pain arises.


Crowded anatomically: We can genetically have a less advantageously designed shaft that makes it easier to get crowded between the tendons of the root canal and the acromion. Over the years, you can also get bone deposits on the acromions below the side and / or the underside of the ac joint, which causes pinching in the area, with pain as a result. The subacromial bursa can swell for a long time (chronic bursitis) and contribute to pain and stiffness in the shoulder.

Hypermobility in the shoulder joint (laxity): Hypermobility in the capsule in the shoulder joint and surrounding ligaments can be genetic or you may have become so through the sport you perform. Swimmers, tennis players and gymnasts are examples of athletes who are affected. The instability in the shaft makes it easier for the rotator cuff tendons to pinch under the acromion.  

Symptoms of impingement


Pain outside, front shoulder / upper arm in activity with the arm and often when lifting the arm out to the side or forward. It can hurt to lie on the affected shoulder. Weakness and stiffness in the shoulder are other symptoms. If the injury is not acute, it is not so common with excruciating pain at rest.

Treatment of impingement


Often a combination of manual treatment and exercise rehabilitation takes place to restore the function of the shoulder joint. In some cases,  shock wave therapy  be a good option. We solve most cases with treatment and training. If this does not help, there is an opportunity to examine the shoulder with  ultrasound diagnostics  to see if you can get more information about what is causing the problems. If we deem it appropriate, we can put one  ultrasound-guided cortisone injection . The next step if there is no improvement is to refer to a doctor for a decision on possible surgery.


Physiotherapy at Alta Vita Physiotherapy

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