Impingement Syndrome

Author: Richelle Morgan PTS, NWS, Fitness Instructor

The rotator cuff is comprised of four muscles commonly referred to as the SITS muscles:

1 - the supraspinatus

2 - the infraspinatus

3 - teres minor

4 - the subscapularis

All four muscles originate on the scapula, insert on the humerus and are responsible for shoulder joint stability and assist in rotation of the humerus in the scapula.

Repeated motion involving the arms or the natural aging process, which involves shoulder motion over many years, may irritate and eventually wear down the tendons, muscles and surrounding structures of the shoulder joint. When the rotator cuff and or bursa are irritated or inflamed, they may get trapped and squeezed between the acromion (small bone structure located on the 'ledge' or medial part of the shoulder, superior to the humerus) and the head of the humerus. Possible sign of this condition include the slow onset of discomfort, pain and weakness in the upper shoulder or upper third portion of the arm, discomfort or pain when sleeping on the shoulder and/or acute due to the result of an injury.

TREATMENT:

1 - stop any activity that can/may aggravate symptoms
2 - medicate with anti-inflammatory medicine
3 - cold therapy or 'cryotherapy'
4 - REST!!!!
5 - gentle stretching exercises
6 - exercises to STRENGTHEN the rotator cuff
7 - if all else fails after 6 to 12 months, arthroscopic or open surgery to repair damage and relieve the pressure on the tendons and bursae


ROTATOR CUFF EXERCISES

Exercise 1:
Start by lying on your stomach on a table or a bed. Put your left arm out at shoulder level with your elbow bent to 90° and your hand down. Keep your elbow bent and slowly raise your left

hand. Stop when your hand is level with your shoulder. Lower the hand slowly. Repeat the exercise until your arm is tired. Then do the whole exercise again with your right arm.


Exercise 2:

Lie on your right side with a rolled-up towel under your right armpit. Stretch your right arm above your head. Keep your left arm at your side with your elbow bent to 90° and the forearm resting against your chest, palm down. Roll your left shoulder out, raising the left forearm until it's level with your shoulder. (Hint: This is like the backhand swing in tennis.) Lower the arm slowly. Repeat the exercise until your arm is tired. Then do the whole exercise again with your right arm.


Exercise 3:
Lie on your right side. Keep your left arm along the upper side of your body. Bend your right elbow to 90°. Keep the right forearm resting on the table. Now roll your right shoulder in, raising your right forearm up to your chest. (Hint: This is like the forehand swing in tennis.) Lower the forearm slowly. Repeat the exercise until your arm is tired. Then do the whole exercise again with your left arm.

Exercise 4:
In a standing position, start with your right arm halfway between the front and the side of your body, thumb down. Raise your right arm until almost level (about a 45° angle). (Hint: This is like emptying a can.) Don't lift beyond the point of pain. Slowly lower your arm. Repeat the exercise until your arm is tired. Then do the whole exercise again with your left arm.