By Ron Handshoe, MSPT
ApexNetwork Physical Therapy
One of the most common shoulder injuries requiring physical therapy intervention is shoulder impingement syndrome. It occurs when the bones of the shoulder interfere (impinge) upon the tendons or bursa.
It is more likely to occur when an individual participates in repetitive activity that involves the hands and arms moving above the head. People who engage in sports such as tennis, swimming, volleyball, and racquetball, as well as occupations like painting, or activities that require one to reach or lift are at greater risk for shoulder impingement syndrome.
Patients may present with variable pain including at the front, side, or back of the affected shoulder joint. Persistent, untreated impingement can lead to pain, loss of functional mobility, decreased strength, and compromised functional abilities.
There are typically two types of impingement syndrome.
Subacromial or External impingement occurs when one of the rotator cuff tendons becomes caught or “impinged” between the head of the humerus (upper arm bone) and the acromion (lateral margin of the scapula/shoulder blade). Poor posture, decreased rotator cuff strength, poor scapular control, and increased forward rounding of the acromion can trigger impingement syndrome.
Internal or “posterosuperior” impingement occurs in overhead athletes, making it more of an “athletic impingement.” The excessive external rotation and abduction during the late cocking phase of athletic movements, such as throwing, leads to adaptive shortening of the posterior rotator cuff and shoulder capsule, anterior joint laxity, loss of internal rotation, and upward and forward translation of the humeral head. This can lead to impingement on the posterior labrum of the shoulder and progressive irritation of the rotator cuff and biceps tendon. Untreated, internal impingement can lead to labral issues and potential SLAP (superior labrum anterior posterior) tears.
Physical therapy treatment aims to address postural deficits, posterior capsule stretching, core stability, and isolated strengthening exercises for the shoulder and periscapular region to address impairments related to shoulder impingement.
If you are experiencing pain or other muscle or joint discomfort, ApexNetwork PT offers complimentary screenings, no referral is necessary. This direct access to your physical therapist provides immediate access to a specialist who can expertly coordinate your plan of care.
To find out more, visit or call any of our offices in Kentucky.
ApexNetwork Physical Therapy locations in Kentucky:
814 Highway 36
513 Maysville Road
272 Kroger Center Drive
156 W. College Ave.