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Understanding Shoulder Impingement Syndrome: Key Structures and Tests

This chapter delves into shoulder impingement syndrome, covering essential structures involved, including the rotator cuff tendons, the long head of the biceps brachii tendon, and the subacromial bursa. It details three primary causes of impingement, such as anatomical variations and repetitive overhead motion. Additionally, the chapter explains the vascularization of the rotator cuff muscles, emphasizing their limited blood supply and its impact on healing. Finally, it highlights how to differentiate between impingement syndrome and rotator cuff tears, as well as what leads to positive results on the Neer and Hawkins Impingement Tests.

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Understanding Shoulder Impingement Syndrome: Key Structures and Tests

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  1. Chapter 13 – The Shoulder and Upper Arm Pages 470 - 476

  2. Quiz • Question #1 • List 5 structures involved in shoulder impingement syndrome. • Question #2 • Describe 3 causes of impingement syndrome.

  3. Quiz • Question #3 • Describe the vascularization of the rotator cuff muscles. • Question #4 • Describe how you would differentiate between impingement syndrome and a rotator cuff tear.

  4. Quiz • Question #5 • What causes a positive test for the Neer Impingement Test and the Hawkins Impingement Test.

  5. List 5 structures involved in shoulder impingement syndrome. • Rotator cuff tendons (primarily supraspinatus) • Long head of biceps brachii tendon • Subacromial bursa • GH joint capsule • Head of humerus • Coracoacromial arch

  6. Describe 3 causes of impingement syndrome. • Anatomical variation in coracoacromial arch • Rotator cuff weakness/fatigue • Repetitive overhead motion • Scapular dyskinesis • GH instability • Poor posture

  7. Describe the vascularization of the rotator cuff muscles. • Relatively poor vascularization • Hinders healing process • Supraspinatus – most susceptible to inflammatory conditions • Humeral head “wringing” the tendon dry of blood and vital nutrients

  8. What causes a positive test for the Neer Impingement Test and the Hawkins Impingement Test. • The motion of the test impinges the rotator cuff (especially the supraspinatus) or long head of biceps brachii tendon between the greater tuberosity and inferior side of acromion process.

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