Rotator Cuff (Impingement) Syndrome Defined
What is rotator cuff (impingement) syndrome? There are three main bones that make up your shoulder joint complex: the humerus, scapula, and the clavicle. The humerus is the bone that attaches to the scapula and is kept in your shoulder by the attachment of your rotator cuff muscles. The rotator cuff consists of four muscles, which reinforce the capsule and control the three basic motions: abduction, internal rotation, and external rotation. These muscles and tendons surround the joint allowing the shoulder to have the most range of motion of any joint in the body. Rotator cuff (impingement) syndrome is defined as any kind of damage or dysfunction to one of the rotator cuff muscles. The four muscle groups that make up the rotator cuff are the supraspinatus, infraspinatus, teres minor and subscapularis. Rotator cuff injuries can be to any combination of the muscles, but rotator cuff (impingement) syndrome involves the supraspinatus. The shoulder girdle functions as part of a kinetic chain linking the neck to the hand. Many muscles in this region attach to the neck and upper torso. By itself the shoulder is an inherently unstable joint composed of a large ball attached to a small socket. The rotator cuff muscles provide stabilization to the humeral head on the glenoid fossa to allow full range of motion of the arm.
Rotator Cuff (Impingement) Syndrome Causes
Rotator cuff (impingement) syndrome is the most common rotator cuff injury of the shoulder that can present certain rehabilitation problems that involves the suprspinatus muscle. Although overuse of the throwing shoulder can contribute significantly to injury, many difficulties begin with improper mechanics and poor conditioning. The increased forces and repetitive overhead motions can cause attritional changes in the distal part of the rotator cuff tendon, which is at risk due to poor blood supply. Sleeping on the side of the rotator cuff injury will increase the pain and delay healing. When the supraspinatus becomes impinged there usually is a pathologic condition where the supraspinatus tendon is irritated against the underside of the distal end of the acromioclavicular joint. There are three classifications found in regard to the type of shape the acromioclavicular joint presents. Type I is a flat appearance, type II is a curved appearance, type III is a hooked appearance and usually contributes to over 50% of the problems involved with the supraspinatus. Rotator cuff (impingement) syndrome can vary with each individual.
Diagnosis and Treatment for Rotator Cuff (Impingement) Syndrome
When evaluating a patient with rotator cuff (impingement) syndrome, orthopedic tests can be very useful in assessing the possible problem. X-rays can evaluate the bony landmarks, but MRI’s are much more descriptive in evaluating the type of acromioclavicular formation as well as ruling out tears, tendonitis, bursitis, etc.
Treatment with conservative measures include:
Correcting postural mechanics
The treatment of rotator cuff (impingement) syndrome depends on the severity,chronicity and associated abnormalities. Earlier detection can make a difference.
This article on rotator cuff (impingement) syndrome is informational and not to be used to diagnose or treat any medical condition