Issue link: https://www.massageandbodyworkdigital.com/i/135515
it came on suddenly. i couldn't fasten my seat belt, put on my coat, or reach to turn off the lamp. i was in pain, but was unsure of the cause. after a frustrating month, i gave up trying to self-diagnose (is anyone else guilty of that?) and went to my chiropractor. he immediately tested me for shoulder impingement syndrome. Shoulder impingement syndrome is one of an array of conditions that indicates a dysfunction in shoulder mechanics. It frequently presents with rotator-cuff injuries and causes pain in the upper arm, decreased and painful range of motion, and interrupted sleep. One possible culprit for impingement syndrome is the scapulohumeral rhythm, the coordination of the scapula in relation to the humerus during movement. There are two muscles that are prime-time players in this rhythm: the serratus anterior and the trapezius. But before looking at strategies and protocols for these muscles, it's important to review the anatomy. Humerus abducted and internally rotated Compression point Subacromial bursa Tear in supraspinatus tendon Long head of biceps shouLDer anaTomy The superior aspect of the shoulder joint is called the impingement area. The primary structures affected in impingement syndrome are the supraspinatus tendon, the subacromial bursa, and the long head of the biceps. When the humerus is internally rotated, the greater tubercle rolls forward, taking the supraspinatus tendon along for the ride. Since the supraspinatus attaches to the top of the greater tubercle, it will collide with the acromion process if the humerus is abducted in the internally rotated position (Image 1). Try internally rotating and abducting your humerus Drawings by Suzanne Dulany. and you'll feel the restriction of the greater tubercle colliding with the acromion process. Just imagine how many times people do this on any given day. You can see why this muscle-tendon unit is so frequently torn and/ or impinged (Image 2). The subacromial bursa lies above the supraspinatus and underneath I www.abmp.com. See what benefits await you. 83