Updated November 2017
If this is the first time you’ve read been reading this article series I recommend going back to part 1 and starting there. A lot of the topics build on top of each other. I don’t want anyone to be confused if they start here!
Part 1 Part 2 Part 3 Part 4 Part 5
Now that you’re all caught up, it’s important to figure out what type of injury you have in your shoulder before you go about trying to rehabilitate it.
Finding out the specific type of injury will help guide your rehab and recovery process. This is why getting an evaluation from a professional becomes so important.
Individuals with Subacromial Impingement Syndrome commonly present with:
- Pain in the anterior or lateral (front or side) aspect of the shoulder
- Pain with overhead activities
- A painful arc (See picture below)
Park et al. performed an excellent study to find the best tests to diagnose subacromial impingement syndrome. They found that the best combination of tests to rule in subacromial impingement syndrome were:
- Hawkins-Kennedy Impingement Test
- Painful Arc Sign
- Infraspinatus Muscle Test
What Park and colleagues found was that if at least 2 out of 3 of these tests were positive then there was a 98% chance that these individuals had subacromial impingement syndrome.
Now keep in mind that the patients in this study had painful shoulders and symptoms specifically in the deltoid. These patients also had a history of relief from a local anesthetic. This is a very specific population that won’t be the same as any Joe off the street with shoulder pain. That being said, this is not going to apply to every population. I do agree that these three tests are a great place to start though when trying to rule in subacromial impingement syndrome. Here are some demos:
Hawkins Kennedy Impingement:
Painful Arc Sign
Note: Some individuals won’t have pain with overhead movements until they start adding weight into the equation. Your shoulders may feel great with lighter weights until you start loading up those overhead presses. Then the painful arc rears its ugly head.
Infraspinatus Muscle Test
So there are three easy tests to help rule in subacromial impingement syndrome. Next installation I’ll go over the specific phases of rehab to go through when you’ve got impingement.
Find Part 7: Stages of Rehabilitation HERE
Want to learn more about how to rehabilitate and prevent future shoulder injury? Check out my latest shoulder course with Dr. Dave Tilley.
Just a few things covered in the course…
- Functional Shoulder Anatomy: What parts of the shoulder are most relevant to your understanding of injury and performance?
- The Most Common Shoulder Injuries Seen in the Gym: Shoulder impingement, rotator cuff tears, biceps tendonitis, AC joint injuries, bursitis and labral tears
- Technical Errors: Advice on where injuries occur in the major lifts and how to fix this
- Advanced Rehabilitation Strategies: Learn how to bridge the gap between basic rehabilitation and high level performance
- Progressive Return to Exercise Programs – Specific exercise protocols to help you return back to pull-ups, bench press, muscle-ups, snatching, jerks and overhead pressing
Click HERE to Learn More about Peak Shoulder Performance
I Heart Shoulder Pain,
Dan Pope DPT, OCS, CSCS, CF L1
References:
1) Cleland, J., & Koppenhaver, S. (2011). Netter’s orthopaedic clinical examination. (2nd ed., pp. 389-428). Philadelphia: Saunders Elsevier.
2) Bin Park, H., Yokota, A., Gill, H., El Rassi, G., & Mcfarland, E. (n.d.). Diagnostic accuracy of clinical tests for the different degrees of subacromial impingement syndrome. (2005). THE JOURNAL OF BONE AND JOINT SURGERY, 87A(7), 1446-1455.