by Peter Culp
Subacromial impingement syndrome (SAIS) refers to the inflammation and irritation of the rotator cuff tendons as they pass through the subacromial space, resulting in pain, weakness, and reduced range of motion within the shoulder. It is common and something that physical and occupational therapy have successfully treated for a very long time. The thought is that the space in the shoulder just underneath the acromion (the lateral and superior aspect of the scapula) is too small and therefore the tendons of the rotator cuff get “impinged” when a person begins to lift their arm up overhead. Because the space in this area of the shoulder is too small, it results in damage to the rotator cuff tendons due to the extra pressure coupled with the limited space.
With that background information, it is interesting to see that recent studies have shown that the size of the space is not actually different in those with or without shoulder pain. One study even found that those who presented with a bigger subacromial space had larger and stronger rotator cuff muscles and tendons.
The idea behind the treatment of shoulder impingement has been focused on increasing the space in the shoulder. However, increasing the size of your subacromial space has no correlation with shoulder pain or function. Subacromial space is most likely the result of conditioned and strong rotator cuff musculature.
In many shoulder impairments, rotator cuff weakness is the culprit behind the dysfunction. It is crucial not to underestimate the importance of these four shoulder muscles! These shoulder muscles include the Supraspinatus, Infraspinatus, Teres Minor, and Subscapularis. These are responsible for the internal and external rotation of the shoulder. The stronger these muscles are, the larger the subacromial space will be. This will help reduce the likelihood of injury and loss of function in shoulders.
Takeaway
So moving forward in your daily workout regimen, do not forget to give some love to your external and internal rotators.