NONOPERATIVE MANAGEMENT OF SECONDARY SHOULDER IMPINGEMENT SYNDROME

Shoulder pain secondary to impingement of the rotator cuff tendons und erneath the coracoacromial arch is a common problem seen in athletes w ho perform repetitive overhead activities. Shoulder impingement has be en classified into primary and secondary types. Several factors contri bute to impingement, including rotator cuff weakness, posterior capsul e tightness, and subacromial crowding. Recently, it has been proposed that scapulothoracic muscle weakness could be a factor that contribute s to impingement. Traditional rehabilitation protocols for shoulder im pingement syndrome stress individualized rotator cuff strengthening. T he authors propose that individualized scapulothoracic muscle strength ening should be a part of any protocol for nonoperative treatment of s econdary shoulder impingement syndrome.