Rehabilitation for subacromial impingement starts at the scapula.

WRITTEN BY JENS ERIK JØRGENSEN ON 28-10-2013 00:00:00. POSTED IN SHOULDER

Push-Up. (Image by: Crossfit)

 

Subacromial impingement, especially secondary subacromial impingement, is a common pathology. The pathology relates to poor posture, which over time may stress soft tissue structures. The treatment is correction of posture, scapular posture ,stabilisation of the scapula, including scapular movement and firing patterns.  An evidence-based approach as to identification and solution of the problem is presented.

Apart from acute injury, pathological posture, overuse and fatigue of the scapular and glenohumeral muscles, neuromuscular adaptations, and muscle imbalances are inter-related causes of secondary subacromial impingement, poor posture being the primary pathology,The muscles surrounding the scapula and the scapula provide the stable base for the glenohumerla joint.This stability is provided by the serratus anterior, trapezius, rhomboids, and pectoralis – the serratus being the most influential. 

Once the clinician has identied the pathologies, the causative factors need to be corrected. First step is to relieve pain, second to correct posture whereafter correct firing patterns and muscle function must be the ultimate goal > From Houglum, J Orthop Trauma Rehab 17 (2013) 54-60. All rights reserved to Elsevier (Singapore) Pte Ltd.

The abstract and article access can be found here.

Winging scapula.
(Image by: Benjamin Roffey)