Impingement syndrome(shoulder pain) is the painful condition of the shoulder resulting from the overuse and anatomical constrictions.Impingement syndrome is a clinical condition where pain occurs during a part of excursion of the gleno humeral joint due to complexion of an element or the rotator cuff against an elemen to fits immediate relation.

Rubbing force on the tendons and bursa caused by the bony process surroundings is termed as impingement. It may caused by the combined effects of rotatorcuff weakness, atrophy, poor flexibility of the posterior structures and the subacromial pressure. Impingement of the rotatorcuff under the surface of the acromion process causes shoulder impingement syndrome.

Causes

• Prolonged overhead activity
• Fatigue of the supra and infra spinatus.
• Inadequate stabilization of the humeral head
• Superior glide of the humerus because of contraction of deltoid muscle causing compression of the contents of the sub acromial space including subacromial bursa and supraspinatus tendon.
• Resulting in bursitis or tendonitis

Clinical Features

Symptoms : Early symptoms of impingement syndrome include generalized aching of the shoulder and pain when raising the arm out from the side or infront of the body.

1. Many of the patients complaint of the pain while sleeping especially rolling on to the effected side.
2. A very reliable sign of impingement is sharp pain when trying reach the back pocket or overhead.
3. If patient tears the supraspinatustendon,pain occurs during shoulder abduction and can be relieved by repairing the torn supraspinatus tendons.
4. As the process continues the discomfort increases and joint may become stiffer.
5. Impingement may be a result rather than a cause of shoulder injury.
6. Greasing/ cracking sound when moving the shoulder.
7. Clicking or popping sensation.
8. Passive ROM is normal but limited active ROM due to pain.
9. Limitation doing overhead activities.