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Causes Of Rotator Cuff Impingement Syndrome

Causes Of Rotator Cuff Impingement Syndrome
Causes Of Rotator Cuff Impingement Syndrome

What Is The Cause Of Rotator Cuff Impingement Syndrome?

Rotator cuff impingement can be caused from a traumatic injury such as a fall, however it is repeated movement of your arm into the impingement zone overhead that most frequently causes rotator cuff impingement. When this overhead movement repeatedly occurs, the rotator cuff gets trapped and pinched under the acromion (end of the shoulder blade which forms a roof to the joint) and with subsequent repetition of this action the rotator cuff can become swollen and painful.
In the non traumatic situation where the individual hasn’t fallen causing rotator cuff impingement syndrome but it is in turn caused through repeated actions for this repetitive pinching of the rotator cuff to occur there are both structural as well as posture & movement related causes.

Structural Narrowing

Primary Causes of rotator cuff impingement refers to any structural factors playing a role in the condition. Some of us are simply born different, some people are born with a smaller sub-acromial space or a hooked acromion type that is more likely to cause impingement.
Some people may develop conditions such as osteoarthritis that can cause the development of subacromial bony spurs further narrowing the available space for the rotator cuff tendons.
As a result of these primary causes and this structural narrowing, you are more likely to pinch, squash, impinge and irritate soft tissues in the subacromial space, resulting in bursitis or rotator cuff tendinopathy.

Dynamic Instability

Secondary causes of rotator cuff impingement can occur if you have an unstable shoulder. An unstable shoulder or dynamic instability in the shoulder is referring in this situation to a shoulder that has a combination of excessive joint movement, ligament laxity and muscular weakness.
In an unstable shoulder, the rotator cuff has to work harder. Overuse of tissues can result in injury as an overworking rotator cuff may fatigue and eventually become inflamed and weakened.
When your rotator cuff fails to work normally, it is unable to prevent the head of the humerus (the ball of the ball and socket joint of the shoulder) from riding up into the subacromial space, subsequently squashing the bursa or tendons sitting or passing through this space.

  • Instability.
  • Poor technique.
  • Bad training habits such as training too hard and not enough rest and recover time.
  • Poor posture of the upper back, shoulder and shoulder blade.

Are other potential causes of rotator cuff impingement that a skilled physiotherapist can help in correcting.

Scapulo-Humeral Rhythm And Rotator Cuff Impingement

Your shoulder blade also known as the scapular is the base of support for your shoulder and arm movements. Poor shoulder blade stability can results in rotation and tipping of your scapular and this may cause your acromion to pinch down into the subacromial structures like the bursa and rotator cuff tendons causing impingement, bursitis, tendon damage and tears.
Normal shoulder blade to shoulder movement pattern is referred to as scapulo-humeral rhythm. Good scapulo-humeral rhythm is required for strong and pain free shoulder function, any alteration of this movement pattern can result in impingement and subsequent pain and injury.

Normalizing Scapulo-Humeral Rhythm

Research has identified poor scapulo-humeral rhythm as a major cause of rotator cuff impingement syndrome. A physiotherapist is skilled in assessment and correction of scapulo-humeral rhythm dysfunction. Physio’s use manual techniques, exercise prescription for scapular stabilisation and any necessary soft tissue lengthening and strengthening exercises as well as taping techniques among other things to help correct any detected issues.


Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance regarding Causes Of Rotator Cuff Impingement Syndrome should consult his or her orthopaedic surgeon, general practitioner, sports medicine specialist or physiotherapist.

Hayden Latimer is the founder of and principle physiotherapist at Sydney Physio Clinic. Since graduating from Otago University, Dunedin, New Zealand he’s gained wide experience practicing across the globe for over 15 years and is now extremely knowledgeable in helping people reduce discomfort and restore function and mobility.

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