A common overuse injury of those who engage in forceful overhead arm movements (e.g. front crawl swimming). The rotator cuff muscles and adjacent soft tissues catch repeatedly on the coracoacromial arch (the arch formed between the coracoid process, the acromion process and the coracoacromial ligament). Repeated pinching causes bursitis and tendinitis and the rotator cuff muscles become scarred and degenerate. A bone spur may also develop underneath the acromion process. Symptoms include gradual onset of pain and tenderness exacerbated by rotatory movements of the humerus. Diagnosis includes the ‘impingement sign’; intense pain when the physician holds the patient's arm straight out in front and pushes it upwards. Treatment includes application of ice at the first signs of the condition, specific conditioning exercises to strengthen and stretch the rotator cuff muscles, anti-inflammatories, and, in extreme cases surgical repair of the muscles and tendons.
Subjects: Sports and Exercise Medicine.