Materiały źródłowe

• #1 Shoulder Impingement Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554518/

  Shoulder impingement syndrome is a painful condition of the upper extremity resulting from a structural narrowing of the subacromial space. […] The estimated prevalence of shoulder complaints is 7% to 34%, often with shoulder impingement syndrome as the underlying etiology. […] Since it was first described in 1852, shoulder impingement syndrome is believed to be the most common cause of shoulder pain, accounting for 44% to 65% of all shoulder complaints. […] Shoulder external impingement should be recognized as a clinical entity that is separate from internal impingement. […] External impingement, often commonly referred to by clinicians and providers as shoulder impingement, is best described as a painful condition of the shoulder that results from the inflammation, irritation, and degradation of the anatomic structures within the subacromial space.

• #2

  https://www.orthobullets.com/shoulder-and-elbow/3041/subacromial-impingement

  Subacromial impingement is the most common cause of shoulder pain which occurs as a result of compression of the rotator cuff muscles by superior structures (AC joint, acromion, CA ligament) leading to inflammation and development of bursitis. […] Subacromial impingement is thought to be a combination of extrinsic compression of the rotator cuff between the humeral head and anterior acromion, coracoacromial ligaments, and acromioclavicular joint. […] Intrinsic degeneration of the supraspinatus leads to inability to balance the humeral head on the glenoid causing superior migration and narrowing of the subacromial space. […] Inflammation of the subacromial bursa due to abutement between the humerus and rotator cuff, and acromion and associated ligaments. […] Subacromial impingement is the first stage of rotator cuff disease which is a continuum of disease from impingement and bursitis to partial to full-thickness tear and massive rotator cuff tears.

• #3 What Is Shoulder Impingement Syndrome? | Pain Free | CHARM

  https://charmaustin.com/understanding-shoulder-impingement-syndrome/

  Shoulder impingement syndrome accounts for up to 65% of all shoulder pain. […] The causes of the common type of secondary shoulder impingement syndrome are often overuse, muscle weakness or imbalance, upper cross strain pattern postures or a combination of these factors. […] Overuse is a common cause of impingement, but rarely is it overuse alone that creates a long-term problem. […] The upper cross strain pattern is dominated by shortened and tight pectoralis muscles in the front of the chest, the SCM muscles in the front of the neck, and sub-occipital muscles at the base of the skull, as well as lengthened and tight upper trapezius and levator scapulae in the upper back and posterior neck. […] A balance of the muscles that stabilize the scapula (shoulder blade) is vital to proper biomechanics at the glenohumeral joint and limits the risk of shoulder impingement, degenerative joint disease, and rotator cuff injury.

• #4 Impingement Syndrome of the Shoulder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5729225/

  Shoulder pain is the third most common musculoskeletal complaint in orthopedic practice. It is usually due to a defect of the rotator cuff and/or an impingement syndrome. […] Patients with shoulder impingement syndrome suffer from painful entrapment of soft tissue whenever they elevate the arm. The pathological mechanism is a structural narrowing in the subacromial space. A multiplicity of potential etiologies makes the diagnosis more difficult; it is established by the history and physical examination and can be confirmed with x-ray, ultrasonography, and magnetic resonance imaging. […] Shoulder impingement is a clinical syndrome in which soft tissues become painfully entrapped in the area of the shoulder joint. […] On the pathophysiological level, it can have various functional, degenerative, and mechanical causes. The impingement hypothesis assumes a pathophysiological mechanism in which different structures of the shoulder joint come into mechanical conflict.

• #5 Shoulder Impingement Rotator Cuff Tendinitis

  https://orthoinfo.aaos.org/en/diseases–conditions/shoulder-impingementrotator-cuff-tendinitis

  Shoulder pain is one of the most common physical complaints affecting people of all ages and for a variety of reasons. The rotator cuff tendons and muscles, which are responsible for moving the shoulder, are a frequent cause of shoulder pain. […] The rotator cuff is a common cause of pain in the shoulder. Pain can happen because of: […] Impingement this happens because the space between the top of your shoulder (acromion) and the rotator cuff tendons becomes smaller when you raise your arm. The acromion can rub against (or impinge on) the tendon and the bursa below, causing irritation and pain. […] Rotator cuff pain is common in both young athletes and older people. […] Young athletes who use their arms overhead for swimming, baseball, tennis, and volleyball are particularly at risk. […] People who do repetitive lifting or overhead activities using the arm, such as paper hanging, construction, or painting are also at risk. […] Pain may also develop as the result of a minor injury. This may happen without an obvious cause or injury.

• #6 Shoulder Impingement Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554518/

  Its anatomic borders define the subacromial space. […] The acromion shape is thought to play a role in the development of external, or „outlet-based” impingement syndrome. […] During the actions of shoulder abduction, forward flexion, and internal rotation, normal shoulder girdle movement results in narrowing of the subacromial space. […] Repetitive pathologic compression, degeneration, and fraying of the rotator cuff tendons are known to contribute to the narrowing of the subacromial space, but it is unknown whether or not the inflamed and damaged tendons cause impingement, or if the narrowed subacromial space causes the tendon inflammation. […] Shoulder impingement syndrome can be described according to either the location of the impingement, characterized as external or internal, and/or the underlying cause of the impingement, referred to as primary or secondary impingement.

• #7 Shoulder Impingement Causes, Symptoms, and Treatments

  https://www.upmc.com/services/orthopaedics/conditions/shoulder-impingements

  Shoulder impingement usually happens when the tendons or fluid-filled sacs (bursa) in the rotator cuff become swollen from overuse. Because there’s little space in the shoulder, the swollen tissue hits against the shoulder bone. This leads to pain and further swelling. […] In some cases, a bone spur grows on the shoulder bone which irritates tissue in the joint. […] Shoulder impingement is more common in athletes and people who use their shoulder muscles at work. […] People are more likely to get shoulder impingement if they: Are older. While shoulder impingement can happen to young athletes, people in their 60s are at the highest risk. […] Play golf, racquet sports, volleyball, or baseball, or engage in other sports that strain the rotator cuff. […] Lift or push items above their head for work. (Carpenters and painters are at a higher risk of getting shoulder impingement.) […] Smoke cigarettes. Smoking can make tissues in the body more prone to damage and swelling.

• #8 Shoulder Impingement Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554518/

  In primary impingement, there is a structural narrowing of the subacromial space. […] Examples of primary shoulder impingement syndrome include those attributable to abnormal acromion anatomy, such as a hooked class III acromion, or swelling of the soft tissues. […] Secondary shoulder impingement syndrome is characterized by normal anatomy at rest and onset of impingement during shoulder motion, likely secondary to rotator cuff weakness, permitting uncontrolled cranial translation of the humeral head. […] Another potential cause of secondary impingement syndrome is a weakness of the trapezius and serratus anterior muscles, limiting the external rotation and rise of the scapula with the abduction of the upper extremity, further narrowing the subacromial space. […] Neer classified shoulder impingement in three categories or stages of severity.

• #9 Impingement Syndrome of the Shoulder

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5729225/

  Primary subacromial impingement is due to mechanical narrowing of the subacromial space, while secondary subacromial impingement is due to a functional disturbance. […] The subacromial impingement syndrome has both primary and secondary forms. Primary impingement is due to structural changes that mechanically narrow the subacromial space; these include bony narrowing on the cranial side, bony malposition after a fracture of the greater tubercle, or an increase in the volume of the subacromial soft tissues due, e.g., to subacromial bursitis or calcific tendinitis on the caudal side. Secondary impingement results from a functional disturbance of centering of the humeral head, such as muscular imbalance, leading to an abnormal displacement of the center of rotation in elevation and thereby to soft tissue entrapment.

• #10 Shoulder Impingement Syndrome – Symptoms, Causes, Treatment & rehab

  https://www.sportsinjuryclinic.net/chronic-shoulder-injuries/impingement-syndrome-shoulder

  Shoulder impingement is classified as internal or external depending on the causes: […] Internal impingement occurs predominantly in athletes where throwing is the main part of the sport, e.g. pitches in baseball or javelin throwers. The underside of the rotator cuff tendons impinges against the glenoid labrum. […] External shoulder impingement is classified as primary or secondary. […] Primary external impingement is usually due to bony abnormalities in the shape of the acromial arch in the shoulder joint. […] It can sometimes be due to congenital abnormalities are known as os acromial, or due to degenerative changes, where small spurs of bone grow out from the arch with age, and impinge on the tendons. […] Secondary external impingement is usually due to poor scapular or shoulder blade stabilization which alters the physical position of the acromion, hence causing impingement on the tendons.

• #11 Causes and Risk Factors of Shoulder Impingement

  https://www.sports-health.com/sports-injuries/shoulder-injuries/causes-and-risk-factors-shoulder-impingement

  Shoulder impingement is a condition that causes pain and pinching sensation in the shoulder. It can also decrease a persons range of motion. Anyone can get shoulder impingement, but people with certain risk factors are more likely to develop it. […] A curved or hooked acromion is a risk factor for shoulder impingement. […] Overuse. People who participate in sports that require frequent and repetitive use of the arms and shoulders, such as baseball, swimming, tennis, and football, are at higher risk of developing shoulder impingement. Additionally, those who frequently perform heavy overhead lifting, such as construction workers or movers, also have an increased risk to develop impingement. […] Curved or hooked acromion. Some peoples natural anatomy makes them more likely to develop shoulder impingement. People who have curved or hooked acromion bones typically have a smaller subacromial space than a person who has a flat acromion.

• #12 Subacromial impingement | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/subacromial-impingement?lang=us

  Subacromial impingement is the most common form of shoulder impingement and occurs secondary to attrition between the coracoacromial arch and the underlying supraspinatus tendon or subacromial bursa, leading to tendinopathy and bursitis respectively. […] Etiology includes acromial shape, acromioclavicular joint degenerative disease, coracoacromial ligament ossification or thickening, shoulder instability, post-traumatic deformity, supraspinatus overdevelopment, and chronic bursitis.

• #13 Shoulder Impingement | St. Charles Health

  https://stcharleshealthcare.org/services/center-orthopedics-and-neurosurgery/what-hurts/shoulder-pain/shoulder-impingement

  Bone abnormalities: Certain anatomical variations, such as the shape of the acromion (a bony process of the shoulder blade), can contribute to the narrowing of the subacromial space and impingement. […] Aging: As we age, the structures in the shoulder can degenerate, including the tendons and bursa. This degeneration can increase the risk of impingement. […] Trauma or injury: A previous shoulder injury or trauma, such as a dislocation or fracture, can lead to structural abnormalities or inflammation that predispose an individual to impingement. […] These factors increase the risk of developing shoulder impingement, but they may not always directly cause the condition.

• #14

  https://www.singhealth.com.sg/patient-care/conditions-treatments/shoulder-impingement

  Shoulder impingement is a common problem, and subacromial impingement is the most common type. This occurs when the tendons of the muscles surrounding the shoulder (rotator cuff) rub under the surface of the acromion bone. […] Repetitive arm movements, especially above 90 degrees, can irritate the subacromial bursa, a fluid-filled sac, causing it to become inflamed and swollen (bursitis). Thickened ligaments and bone spurs may also narrow the space for the tendons to move, thus increasing the risk of impingement and bursitis, especially in those with prior injuries or above the age of 40 years. […] There are various reasons that can lead to the development of this condition. Subacromial impingement could be due to: […] Muscle imbalance. This refers to the tone or strength of the muscle around a joint and may be caused by unbalanced training regimes or poor technique. […] Mechanical reasons. Bone spur formation on the surface of the acromion, reducing the subacromial space and increasing the risk of impingement. […] Direct injury to the tendon.

• #15 Understanding Shoulder Impingement Syndrome

  https://dinesorthopedics.com/understanding-shoulder-impingement-syndrome-causes-symptoms-and-treatments-for-rotator-cuff-tendinitis/

  Critical shoulder angle: A larger angle between the glenoid and acromion can predispose individuals to impingement. […] 2. Rotator Cuff Weakness or Imbalance […] Weakness or imbalance in the rotator cuff muscles can alter shoulder mechanics, causing the humeral head to shift upward and compress the subacromial space. […] 3. Poor Posture […] Prolonged poor posture, especially rounded shoulders and forward head position, can contribute to shoulder impingement by altering scapular positioning and muscle function. […] 4. Repetitive Overhead Activities […] Occupations or sports that involve frequent overhead motions (e.g., painting, swimming, tennis) can lead to rotator cuff tendinitis and subsequent impingement. […] 5. Age-Related Degeneration […] As we age, the tendons of the rotator cuff naturally degenerate, becoming less flexible and more prone to irritation and inflammation.

• #16 Causes and Risk Factors of Shoulder Impingement

  https://www.sports-health.com/sports-injuries/shoulder-injuries/causes-and-risk-factors-shoulder-impingement

  Prominent coracoid. The coracoid is a small projection from the shoulder blade. Like people who have hooked or curved acromions, some people have prominent coracoids. These people are more susceptible to another, less common type of shoulder impingement called subcoracoid impingement. […] Shoulder instability. Shoulder instability refers to when shoulder muscles, tendons, and ligaments no longer secure the shoulder joint causing pain. As a result, the shoulder is prone to partial dislocation, dislocation, and other conditions, such as shoulder impingement. […] Previous shoulder injuries. People who have sustained injuries to the shoulder joint, such as a torn labrum, may be at risk for developing shoulder impingement in the future. […] Bone spurs. Bone spurs are projections that can cause the subacromial space to narrow and become smaller. As a result, there is less room for tendons and other soft tissues, making impingement more likely.

• #17 Shoulder Impingement Syndrome: Symptoms & Treatment | HSS

  https://www.hss.edu/condition-list_shoulder-impingement.asp

  This where the scapula moves into an incorrect position often sticking out abnormally, causing faulty movement and, sometimes, impingement. […] Less often, an impact injury from a fall or direct blow to the shoulder can cause inflammation of soft tissues, which then become impinged inside a joint.

• #18 What is the truth about shoulder impingement and what really causes it

  https://sosphysiotherapy.ca/what-is-the-truth-about-shoulder-impingement-and-what-really-causes-it/

  Shoulder impingement syndrome is the irritation of those above structures, such as the rotator cuff tendons and bursa as they pass through the space in your shoulder. This can be caused by a number of factors including posture, the way your neck and back move, and the strength of your muscles. […] What could other causes of your shoulder impingement pain be? If there is tightness of your neck joints and muscles, it may cause irritation or compression on some nerves. Muscle imbalances strong vs weak muscles can add to poor positioning of your humerus causing more compression in the area. Repetitive overhead motions of the arm like throwing sports and painting can further aggravate structures if they are already being impinged. Stiffness in your upper back can also lead to reduced motion of the shoulder leading to further restrictions. Changes with aging can also narrow the space increasing your chance of structural irritation.

• #19 Shoulder Impingement (Rotator Cuff Tendinitis)

  https://my.clevelandclinic.org/health/diseases/shoulder-impingement-rotator-cuff-tendinitis

  Shoulder impingement happens when bones in your shoulder rub against or pinch your rotator cuff. It happens when swelling in your shoulder makes your rotator cuff too big to fit comfortably between your bones. […] Shoulder impingement is almost always an overuse injury. This means it happens over time when an activity or motion repeatedly puts too much stress on your shoulder joint and rotator cuff. […] Healthcare providers call the kinds of movements that cause shoulder impingement overhead rotation motions any repetitive motion that requires you to twist and turn your shoulders with your arms raised. […] Some people develop shoulder impingement without an obvious cause (idiopathically). Its also possible for trauma (like a fall, car accident or sports injury) to cause impingement suddenly. […] Anything that irritates your rotator cuff and the tissue in your shoulder joint can cause shoulder impingement.

• #20 Shoulder Impingement Syndrome: Practice Essentials, Etiology, Epidemiology

  https://emedicine.medscape.com/article/92974-overview

  In all Neer stages, etiology is impingement of the rotator cuff tendons under the acromion and a rigid coracoacromial arch, eventually leading to degeneration and tearing of the rotator cuff tendon. […] Causes of primary impingement are as follows: Increased subacromial loading, Acromial morphology (A hooked acromion, presence of an os acromiale or osteophyte, and/or calcific deposits in the subacromial space make patients more predisposed for primary impingement.), Acromioclavicular arthrosis (inferior osteophytes), Coracoacromial ligament hypertrophy, Coracoid impingement, Subacromial bursal thickening and fibrosis, Prominent humeral greater tuberosity, Trauma (direct macrotrauma or repetitive microtrauma), Overhead activity (athletic and nonathletic). […] Causes of secondary impingement are as follows: Rotator cuff overload/soft tissue imbalance, Eccentric muscle overload, Glenohumeral laxity/instability, Long head of the biceps tendon laxity/weakness, Glenoid labral lesions, Muscle imbalance, Scapular dyskinesia, Posterior capsular tightness, Trapezius paralysis.

• #21 Shoulder Impingement Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554518/

  In stage I, impingement primarily results from edema, hemorrhage, or both and is classically seen with overuse-type mechanisms. […] Stage II is characterized by greater fibrosis and irreversible tendon changes. […] A rupture or tear of the tendon may result from chronic, longstanding fibrosis and is seen in stage III shoulder impingement syndrome. […] Other extrinsic risk factors that may predispose to the development of impingement syndrome include bearing heavy loads, infection, smoking, and fluoroquinolone antibiotics. […] The incidence of shoulder impingement syndrome rises with age, with peak incidence occurring in the sixth decade of life. […] Potential pathologies that may result include rotator cuff tendonitis or tear, bicipital tendonitis or tear, or adhesive capsulitis.

• #22 Shoulder Impingement Syndrome: Symptoms & Treatment | HSS

  https://www.hss.edu/condition-list_shoulder-impingement.asp

  For example, the subacromial space can become narrowed as a result of diseased or damaged soft tissue that lies within the space. […] Even when anatomy plays a role, causation is often multifactorial. […] Age-related changes, namely degeneration of the tendons and bursa in the shoulder, make people more susceptible to tendinopathy, bursitis and other related conditions that can lead to impingement. […] Activities that may trigger or exacerbate shoulder impingement include: […] Repetitive arm movement especially overhead arm movement from athletic or occupational activity can lead to tendinopathy and resulting impingement. […] Lack of exercise of the arm and shoulder weakens the muscles, which puts greater strain on tendons. […] Frequent slouching can alter the alignment of the shoulder joint and make one more prone to impingement.

• #23 Subacromial impingement : diagnosis, causes and treatment | Doctor Philippe Paillard Office

  https://www.orthopaedic-surgery-paris.com/subacromial-impingement-diagnosis-causes-and-treatment/

  From the age of 40, pain in the shoulder is often caused by what is called subacromial impingement, a syndrome linked to the aging of the rotator cuff tendons. […] With age, the tendons lose their elasticity, in particular the supraspinatus tendon, which is most often affected. […] As they thicken, they rub against the acromion, the bony process located on the scapula, resulting in the formation of a bone spur called osteophyte. […] This in turn damages the superficial part of the tendon, accelerating its wear. […] As the subacromial impingement progresses, the pain worsens.

• #24 Shoulder Impingement Syndrome: Symptoms, Treatments, Causes, and More

  https://www.webmd.com/arthritis/impingement-syndrome

  Shoulder impingement syndrome is a common cause of shoulder pain. It occurs when there is impingement of tendons or bursa in the shoulder from bones of the shoulder. Overhead activity of the shoulder, especially repeated activity, is a risk factor for shoulder impingement syndrome. Other risk factors include bone and joint abnormalities. […] Over time, impingement syndrome can lead to inflammation of the rotator cuff tendons (tendinitis) and bursa (bursitis). If not treated appropriately, the rotator cuff tendons can start to thin and tear. […] If tendons are injured for a long period of time, the tendon can actually tear in two, resulting in a rotator cuff tear. This causes significant weakness and may make it difficult for the person to elevate their arm. Some people can have rupture of their biceps muscle as part of this continuing impingement process. […] If symptoms persist or if significant weakness is present, then your doctor may perform an ultrasound, MRI, or arthrogram to rule out a rotator cuff tear. If the cuff is torn, surgery may be necessary to repair it.

• #25 Shoulder 'Impingement’ – Causes, Symptoms & Treatment

  https://www.thrivephysioplus.com.au/shoulder/shoulder-impingement-symptoms-treatment/

  There was moderate evidence that surgical treatment is not more effective than active exercises on reducing pain intensity caused by shoulder impingement. […] Remember, outside of sinister causes like cancer and a few select conditions (dislocation in the young population for example), it doesnt matter and you should get great improvements in pain and function with a supervised exercise program from an experienced physiotherapist. […] It can show signs of impingement, but remember, shoulder impingement has shown to be more myth than fact and so isnt likely the reason you have shoulder pain. […] Shoulder impingement pain is reduced by hands-on therapy in the short term, and strengthening of the shoulder muscles for long-term results.

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