Subacromial Impingement Flashcards
Outlet
external
sub-acromial, in the jt space
Primary SIS & Secondary SIS
Non-Outlet
internal
not in sub-acrom space
Posterior-Superior IS
Neer Stage 1
inflammation, edema, hemorrhage.
Affects <25 yo.
Reversible w/ conservative tx.
Neer Stage 2
fibrosis, tendinopathy (usually supraspin), or chronic from Stage 1 to irreversible state.
Affects 25-40 yo.
Continued wearing of musc/tdn.
Tendinopathy = tdn swells w/ no signs of inflam cells.
Neer Stage 3
bone spurs, tdn rupture.
Affects >40 yo.
Partial or full thickness tdn tear.
Bone spurs under acrom as a result of mech disruption.
where is the avascular zone
where supra tdn attaches
Primary SIS characteristics
Block
Mechanical GH impingement.
Altered/reduced subacrom space.
Secondary SIS characteristics
Instability
Uncertain GH positioning.
Primary SIS is caused by
RC weak/inflam/tendinopathy.
Post capsule tightness.
Morphology/shape of acrom.
Posture.
Secondary SIS is caused by
RC weak/tear. Capsular laxity. Multidirectional instability. Neuromusc inhibition. Scapular dyskinesia.
Primary SIS symptoms
Pain at night.
Pain w/ OH.
C/o stiffness.
Secondary SIS symptoms
Young, OH athlete.
Pain w/ OH.
Hx of instability, hypermobility.
Non-Outlet is common in what population
OH athletes (repetitive injury) Associated w/ 90° ABD & full ER
Non-Outlet is caused by
Associated w/ 90° ABD & full ER
Due to contact btwn post/sup labrum & underside of supra/infraspinatus.
Risk Factors
Repetitive movements of shoulder/wrist/hand.
Work requiring prolonged strength of upper arms.
Hand/arm vibration.
Poor posture.
High psychological workload.
Regular sport activities (>3 hr/wk for >10mo/yr).
