Throwing athletes tend to have laxity in the shoulder joint from repetitive overhead activities which causes the shoulder structures to become stretched. The rotator cuff muscles can stabilize this laxity but when they become fatigued the tissues between the humerus and the acromion get compressed and microtrauma results. Other causes include , poor posture, faulty positioning of the scapula, and structural variations in the shoulder complex. Initially the pain will be felt near the tissue structures being impinged, on resisted muscle contraction, and when the tissue is stretched. If left untreated a painful arc will be felt with overhead activities and weakness or poor endurance in the scapular stabilizers and rotator cuff muscles will be noted.
Impingement syndrome is linked to several other specific injuries to the shoulder.
This is because the impingement may be secondary to the instability. If significant shoulder instability is found, an orthopedic consult may be indicated to determine the exact cause and level of risk the athlete faces with a return to athletic participation. Rotator cuff tears can occur from direct trauma to the shoulder and all athletes presenting with signs and symptoms of impingement syndrome should also be screened for rotator cuff tears. Ice wrapped around the shoulder for 20-25 minutes is an effective way to aid in decreasing the inflammation found with impingement. By improving these aspects of the shoulder complex you greatly enhance the stability of the joint.