What is Posterior / Superior Shoulder Impingement?

What is Posterior / Superior Shoulder Impingement?

66% of all shoulder problems are impingement injuries. Impingement is diagnosed as either primary, secondary, or posterior shoulder pain (internal). An impingement means that the soft tissue of your shoulder gets “pinched” where your collar bone (clavicle) and head of your shoulder bone meet. This causes you to have pain when raising your arm overhead or out to the side and experience posterior shoulder instability. This can occur either through wear and tear of the shoulder (primary impingement), muscle weakness, or shoulder instability imbalance (secondary impingement), or because of tightness in the capsule that surrounds your shoulder joint (posterior). A posterior shoulder impingement is typically seen in throwing athletes, volleyball and tennis players, and occupations with repetitive overhead activity.

There are many tests for diagnosing shoulder impingement. Your doctor or physical therapist can evaluate the joint mobility of your shoulder to assess how tight the shoulder capsule is and determine the next course of treatment. When the back part of your shoulder becomes bound down it causes the shoulder joint to ride forward and up in the socket.

Treatment for a posterior impingement includes stretching the muscles of your chest and neck and strengthening the muscles of the shoulder blade to bring the shoulder down and back. Treatment will also include manual stretching by your physical therapist to loosen the posterior capsule and allow the shoulder to sit in the socket at a better position to allow more freedom for overhead motion.

Treating Shoulder Impingement

Treatment will typically last from 4-6 weeks to allow for retraining of your muscles and loosening of the shoulder capsule to occur. You will be seen for physical therapy three times a week and also prescribed a daily home exercise program for your shoulder problem. Initial soreness may be experienced, but you should let your physical therapist know if pain is increasing or if any of the exercises you are performing hurt.

If conservative treatment fails, a surgeon may go in to release the capsule to allow the shoulder to slide back and down into the joint space. After surgical treatment, you can expect to be in physical therapy for pain relief and muscle re-education.

Most people experience relief of symptoms and are able to return to their daily activities. Although shoulder impingement is common, it is very treatable while working closely with your healthcare professional team. Your doctor or physical therapist will be able to answer any additional questions you may have regarding your shoulder pain.

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The medical information contained herein is provided as an information resource only, and does not substitute professional medical advice or consultation with healthcare professionals. This information is not intended to be patient education, does not create any patient-provider relationship, and should not be used as a substitute for professional diagnosis, treatment or medical advice. Please consult with your healthcare provider before making any healthcare decisions or for guidance about a specific medical condition. If you think you have a medical emergency, call your doctor or 911 immediately. IvyRehab Network, Inc. disclaims any and all responsibility, and shall have no liability, for any damages, loss, injury or liability whatsoever suffered as a result of your reliance on the information contained herein.

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