Note
You can find the medical-orthopedic part under our topic Impingement Syndrome.
Synonyms
- Shoulder bottleneck syndrome
- Shoulderenge
- Painful shoulder
- Painful bow
- Subacromial Impingement
- Subacromial narrowness
- PHS = Periarthritis humero scapularis
Definition
The term impingement syndrome is derived from the Anglo-American language and means something like bumping, entrapment, whereby at the shoulder, as a rule, an entrapment between the ball of the humeral head and the bony acromion is meant.
Symptoms
In the range of approx. 60-120° spread – or lifting movement of the upper extremity, sharp pulling pain mostly occurs in the front, lateral upper arm area, which is so strong that it causes a change in the movement sequence or an interruption of movement. If the movement is continued, the pain recedes or disappears completely, as the position of the shoulder joint head in relation to the acromion changes (increasingly in external rotation – external rotation).
This phenomenon is referred to in medical terminology as “painful arc”. The pain is caused by connective tissue structures (tendons, capsule parts, bursae) being trapped in the anatomically narrow tunnel between the head of the shoulder and the acromion. This tunnel narrows when the arm is spread at an angle of approx.
60°. Cleaning windows, blow-drying hair, putting things in the closet or reaching for the seatbelt can be torture. The pain is mostly located in the area of the lateral upper arm, whereby the deltoid muscle located there is not causally affected, sometimes it radiates towards the elbow or shoulder blade.
If the pain radiates up to the elbow joint, it may be suspected that the cervical spine is also responsible for the pain. In most cases, the pain is stronger during active movements, which are performed by the patient himself, than when the shoulder is moved passively, for example by a doctor or therapist. Furthermore, the quality of pain depends on the way the movement is performed. A small change in the position of the shoulder in the direction of internal or external rotation can increase or decrease the pain during the abduction movement. Often there is also a nightly pain at rest and patients can no longer lie pain-free on the affected shoulder.
All articles in this series:
