Pain Trigger

Frequently affected are adults between 20 and 60 years of age who do not primarily use their arm for heavy physical work. Poor posture, a muscularly unstable shoulder and reduced physical fitness favour the development of an impingement syndrome. The first pains often occur after unaccustomed stresses such as renovation, spring-cleaning or unknown sporting activities.

An accident involving the shoulder – the dog suddenly tears at the leash, the arm gets caught in the door frame – can also lead to an inflammatory thickening of the tendons, often combined with functional disorders in the rib and/or thoracic vertebral joints, ultimately leading to impingement syndrome. However, overexertion in sports can also lead to shoulder problems for people who are in training; these are often affected: A further trigger for acute impingement can be caused by “wrong lying” on the shoulder joint. Those affected wake up in the morning with severe shoulder pain and the inability to lift the arm.

In Germany, unfortunately, 80x80cm pillows are still in use, on which the head, cervical spine and shoulder lie. The cervical spine does not have sufficient support with this type of pillow, the shoulder is strained by the pressure of the own weight on the pillow in a forward movement over several hours. If the mattress is very hard in the shoulder area, the pressure load on the shoulder increases, because the shoulder cannot sink sufficiently in the lateral position.

The shoulder joint head slips (subluxates) forward and, in the morning after getting up, pinches the tendons during the spreading or lifting movement. The consequences are acute pain and the inability to lift the arm.

Javelin Thrower
Shot-putters
Volleyball players.

Diagnosis

The diagnosis is primarily made by the doctor by taking the medical history – anamnesis, a functional examination, possibly X-ray or MRI. You can find the medical therapy under the topic Impingement – Syndrome. Interdisciplinary cooperation with the physiotherapist and the common view of the X-rays are desirable and will significantly improve the efficiency of the physiotherapeutic treatment.