Shoulder Impingement (Care of the Young Athlete)
Shoulder impingement is an overuse injury that
causes achy pain on the front or side of the shoulder. The pain is felt most
when the arm is overhead or extended to the side. Shoulder impingement also is
called rotator cuff tendonitis, subacromial impingement, supraspinatus
tendonitis, and shoulder bursitis.
Shoulder impingement is common in swimmers and
athletes who play baseball, tennis, and volleyball. It can also occur in weight
lifters, gymnasts, divers, and rowers. Causes include a rapid increase in
overhead activity, weakness or strength imbalance in the rotator cuff or
scapular muscles, postural abnormalities, shoulder joint instability, or
improper training or technique.
The following is information from the American
Academy of Pediatrics summarizing treatment phases and goals for shoulder
Phases and Goals of Shoulder Impingement Treatment
Treating shoulder impingement involves limiting
activities that cause pain and using ice and nonsteroidal anti-inflammatory
drugs (NSAIDs) to help reduce inflammation. The symptoms of shoulder impingement
will subside with rest, but the condition will not fully resolve until the
underlying causes have been identified and corrected.
1. Limit overhead activity
2. Ice, NSAIDs.
1. The other phases of
2. Swelling inside the
3. Pain may be reduced by
1. Correct poor posture.
2. Restore strength to
1. Stretch anterior chest
2. Use elastic tubing or
|Proper posture is very importantóchest out and shoulders
back. These exercises strengthen parts of the body that help
with posture and holding the shoulder bones in the proper
1. Continue with aspects of
2. General conditioning,
3. Lower extremity and trunk
|Strength in the legs, hips, and trunk is crucial for maximizing
arm strength and power with throwing or tennis. This part of
rehabilitation can usually take place while shoulder pain is
1. Resume overhead motion
2. Correct technique or
1. For pitchers, follow a
2. Consider biomechanical
|Continue with maintenance exercises that have been prescribed
and any corrections in technique or training regimens that
helped with recovery. Include exercises that help prevent the
strength imbalances that occur with repetitive overhead activity
and contribute to injury.
|Athletes should continue select important exercises after
therapy. These are typically not as extensive or time-consuming
as the rehabilitation program.