impingement

Among all shoulder injuries, shoulder impingement syndrome is more common and is considered as the most common cause of pain and motion restriction in the shoulder region.

Major research on the treatment of shoulder impingement syndrome is based on physiotherapy and various exercises.

The anterior impingement test is performed with the patient in supine position.

Pelvic tilt is a measurement of functional anteversion, and inclination of the pelvis can be affected by lumbosacral and hip pathologies such as scoliosis, femoroacetabular impingement, and acetabular or femoral dysplasia, among others.

In 2013, Tashjian performed a systematic review of leven randomized controlled trials for the effectiveness of surgery in sub-acromial impingement syndrome.

This study indicated that there was moderate evidence that surgical treatment is not more effective than active exercises on reducing pain intensity caused by shoulder impingement. Moreover, this study recommended conservative treatment as a first choice of treatment of shoulder impingement in first or second grade.

The primary endpoints of the study were to assess the effectiveness of hip joint arthroscopy in the treatment of femoroacetabular impingement in patients with joint gap stenosis exceeding the assumed, hypothetical limit point of 3 mm, and to determine how quickly post-operative patients were able to return to work and to physical activity.

Eventually, the prospective study involved 92 patients, operated during the years 2012-2014 by means of the arthroscopic technique for CAM-type femoroacetabular impingement (Figure 1).

(19, 23-25) Moreover, there is a high prevalence of asymptomatic abnormal radiographic impingement morphology in the adolescent population.

(29) Furthermore, although FAI is most commonly associated with developmental morphogenic changes, a high index of suspicion should also be maintained for patients with clinical signs of impingement secondary to trauma or previous surgeries undertaken for correction of developmental hip pathology.

American surgeon Charles Neer described shoulder impingement as reduced structural space between the head of humerus and the acromion of spine of scapula.1

Shoulder impingement syndrome is the most common disease of the shoulder region that occurs by bony variations due to rotator cuff (RC) and scapular muscles imbalance and improper posture.2 The prevalence of shoulder impingement syndrome is highest (36%) among the people with shoulder pain.3 In Iran, the prevalence of shoulder pain was found to be 41.6% in athletic population.4 RC tendinopathy accounts for 69% to 75% of shoulder pain cases.5