Primary vs. Secondary

Shoulder Impingement is very much as it sounds: a part of the shoulder is getting pinched/squeezed/impinged by another part.  The key to successful treatment is to determine what is causing these structures or tissues to become impinged, and then directing treatment to this area to normalize function.

To begin with, it is important to determine if the impingement is occurring due to an anatomical variation (Primary) or if it is the result of a dysfunction in the mechanics of the joint or muscle complex (Secondary).  Anatomical variations are often due to degeneration of the clavicle or having a congenital variant of the Acromion Process.  Secondary Impingement can come from a wide variety of triggers which create improper joint and muscle function.  One of the big contributors can be rotator cuff weakness.  The rotator cuff is comprised of 4 muscles that accounts for the stability of the shoulder joint.  When these muscles are not functioning like they should, the humerus will slide up, limiting the space inside the joint.  The biggest question however, will be to determine not only what is creating the movement dysfunction, but to find out why.  Often, rotator cuff weakness is not necessarily from a specific injury but can be attributed to posture, joint mechanics, and poor ergonomics.  

If you are experiencing shoulder pain, the best next step is to receive a proper examination to determine a plan of action.  At Central Wellness Chiropractic, we strive to tailor every exam and treatment to the individual.  If you are located in the Seattle area, we are conveniently located between Capitol Hill and the Central District.  Please visit our website for more information on our clinic and also check out this video for a more in-depth description on what is occurring in different types of shoulder Impingement: