Shoulder impingement: Biomechanical considerations in rehabilitation

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117 Scopus citations


Shoulder impingement is a common condition presumed to contribute to rotator cuff disease. Impingement can occur externally with the coracoacromial arch or internally with the glenoid rim. Normal scapulothoracic motions that occur during arm elevation include upward rotation, posterior tilting, and either internal or external rotation. These scapulothoracic motions and positions are the result of coupled interactions between sternoclavicular and acromioclavicular joints. The sternoclavicular and acromioclavicular joints both contribute to scapulothoracic upward rotation. Posterior tilting is primarily an acromioclavicular joint motion. The sternoclavicular and acromioclavicular joint motions offset one another regarding final scapulothoracic internal/external rotation position. This manuscript discusses these coupled interactions in relation to shoulder muscle function. Two case examples are presented to demonstrate application of understanding these interactions and potential mechanisms of movement abnormalities in targeting treatment interventions for movement based subgroups of impingement patients.

Original languageEnglish (US)
Pages (from-to)33-39
Number of pages7
JournalManual Therapy
Issue number1
StatePublished - Feb 2011

Bibliographical note

Funding Information:
This manuscript was supported in part by NIH grants K01HD042491 and R03ND053399 from the National Institute of Child Health and Human Development . The content is solely the responsibility of the authors and does not necessarily represent the views of the National Institute of Child Health and Human Development or the National Institutes of Health.


  • Exercise
  • Human movement system
  • Physical therapy
  • Rotator cuff disease


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