Ludewig, Man Ther 2010 - Shoulder Impingement: Biomechanical Considerations in Rehabilitation

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Shoulder Impingement: Biomechanical Considerations in Rehabilitation

Ludewig, Braman·Man Ther·2010·233 citations·Review article

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Shoulder impingement is a common condition presumed to contribute to rotator cuff disease. Impingement can occur externally with the coracoacromial arch or internally with the glenoid rim. Normal scapulothoracic motions that occur during arm elevation include upward rotation, posterior tilting, and either internal or external rotation. These scapulothoracic motions and positions are the result of coupled interactions between sternoclavicular and acromioclavicular joints. The sternoclavicular and acromioclavicular joints both contribute to scapulothoracic upward rotation. Posterior tilting is primarily an acromioclavicular joint motion. The sternoclavicular and acromioclavicular joint motions offset one another regarding final scapulothoracic internal/external rotation position. This manuscript discusses these coupled interactions in relation to shoulder muscle function. Two case examples are presented to demonstrate application of understanding these interactions and potential mechanisms of movement abnormalities in targeting treatment interventions for movement based subgroups of impingement patients.

Copyright remains with the authors and publisher.

Shoulder Impingement: Biomechanical Considerations in Rehabilitation

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Shoulder Impingement: Biomechanical Considerations in Rehabilitation

Ludewig, Braman·Man Ther·2010·233 citations·Review article

Free Full Text·DOI·PubMed

|

Shoulder impingement is a common condition presumed to contribute to rotator cuff disease. Impingement can occur externally with the coracoacromial arch or internally with the glenoid rim. Normal scapulothoracic motions that occur during arm elevation include upward rotation, posterior tilting, and either internal or external rotation. These scapulothoracic motions and positions are the result of coupled interactions between sternoclavicular and acromioclavicular joints. The sternoclavicular and acromioclavicular joints both contribute to scapulothoracic upward rotation. Posterior tilting is primarily an acromioclavicular joint motion. The sternoclavicular and acromioclavicular joint motions offset one another regarding final scapulothoracic internal/external rotation position. This manuscript discusses these coupled interactions in relation to shoulder muscle function. Two case examples are presented to demonstrate application of understanding these interactions and potential mechanisms of movement abnormalities in targeting treatment interventions for movement based subgroups of impingement patients.

Copyright remains with the authors and publisher.

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