Rotator Cuff Impingement
Rotator cuff impingement has been mentioned in the other sections in which I talk about the rotator cuff muscles.
Cuff impingement can be caused by many different factors and can lead to a range of rotator cuff damage including a rotator cuff tendon tear.
Some of the factors that lead to rotator cuff impingement are completely beyond your control.
There are a variety of things in the shoulder joint that can complicate things for us all.
It is important to realise that absolutely anything that reduces the available shoulder space may lead to impingement and therefore to rotator cuff damage and lets say a rotator cuff tendon tear.
A good and simple to understand example is how the shape of the acronium, they are not all the same, can have a dramatic effect on the impingement of the rotator cuff muscles.
Acromion typesThere are known to be three distinct types of acromion, as shown in the diagram below. The type I acromion, which is flat, is the "normal", most commonly occurring, acromion.
The type II acromion is more curved and downward dipping, and the type III acromion is hooked and downward dipping. The further hooked or dipping the acronium; the more it obstructs the outlet for the rotator cuff muscles.
Various studies have shown, not surprisingly, an increased incidence of rotator cuff impingement in people with type II and type III acromions.
There is little that anyone can do about the shape of their own acromion.
Other potential causes of rotator cuff impingementThere are other factors that can significantly reduce the available shoulder space.
One of the main reasons is a subacromial spur which is simply a bone spur on the underside of the acromion.
Indeed any acromial defect that reduces the gap between the humerus and the acromion can lead to rotator cuff impingement and rotator cuff damage. I explained about the role of bursa in aiding muscle movement but even something as simple as having a thick subacromial bursa can cause rotator cuff pain.
The most important factor in any potential rotator cuff impingement however is the health of the rotator cuff muscles.
Location of the Subacromial bursa
If you are unlucky enough to have one of the potential problems mentioned above then having healthy rotator cuff muscles is even more important to you. Shoulder stability is so important.
Having strong, healthy rotator cuff muscles will hold the humerus head tightly in place and help to prevent impingement regardless of any of these other factors.
Rotator cuff impingement - break the cycleThere is, in relation to your rotator cuff pain, an almost self fulfilling cycle. This is in fact repeated throughout the body with lots of different types of muscle pain and weakness gradually getting worse rather than better because we fail to act. Let me explain in relation to rotator cuff damage.
It is all too common that a Rotator cuff impingement leads to rotator cuff damage. The weakened rotator cuff muscles develop a rotator cuff tendon tear and you suffer rotator cuff pain. This is an all too common fact but why does it happen that way?
Anything that causes a person to suffer pain such as rotator cuff pain, can lead to a further weakening of the rotator cuff muscles. Indeed shoulder pain from any cause, such as overuse or injury, may lead to disuse or weakness of the rotator cuff muscles.
Let's be honest about this, if something hurts then we are less likely to use it. But by not exercising and strengthening we can actually make matters worse and increase the chances of rotator cuff impingement.
How is it made worse? Well think about it like this. You have rotator cuff pain in the shoulder let's say from a rotator cuff impingement.
As a result you don't use the shoulder so much or exercise quite as regularly, if at all. This means the rotator cuff muscles are gradually weakened through lack of exercise.
As a direct result of this gradual weakening the rotator cuff muscles have less power to hold the humerus firmly in place. As a consequence the humerus is able to "ride up" increasing any rotator cuff impingement that there may have been. Thus it causes more pain and begins to reinforce the cycle. Repeated gradually over time the effects can be all too painful.
Taking action now to improve the strength and the health of your rotator cuff muscles will help to improve or prevent any impingement. Once again this can be done by anyone it is not about handling great heavy weights it is just sensible exercise. Seriously guys, if I can do this, and I have, then you can too, that is my goal.
Rotator cuff muscles - a unique combination
In the pages on rotator cuff anatomy I have talked about what makes your rotator cuff muscles so unique. It is the ability to aid in arm movement whilst holding it tight to the shoulder blade.
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