Okay, so how do you know if you have rotator cuff impingement syndrome.

One of the oldest but most useful manual tests is to passively flex a patient’s arm with a slight internal rotation. At some point if the humeral head is pinching down on the rotator cuff tendon onto the acromion, pain will cause the patient to fight the motion and avoid the arm from being flexed and internally rotated further.

This is another variation of a manual impingement test. Your doctor or therapist will apply compression downward on your acromion with adduction and internal rotation of your arm, if you have pain you are positive for an impingement.

Physicians use a variety of other tests as well to determine if you have rotator cuff impingement syndrome.

One of the tests they use is to inject cortisone into the sub-acromial space, if you feel relief it is most likely swelling and inflammation causing pressure on to the rotator cuff tendon which indicates an impingement.

X-rays can also assess the position of the glenohumeral head and indicate if there are bone spurs that could be contributing to impingement.

Calcific tendinitis of your rotator cuff tendons can also show up on an x-ray. This is literally a hardening of the rotator cuff tendons and this attributed to a lack of blood supply to the muscle tendon and long periods of inflammation, yet another reason to address the primary cause of your impingement.

Indirectly, when patients respond positively to a series of strengthening and stretching exercises to address rotator cuff impingement, this in itself could positively identify that they had some form of impingement.

The assessment evaluation tools physicians should use cannot be ignored and is the primary source of determining the real cause of your shoulder pain since it may be a combination of any of the conditions listed below:

-Outlet impingement
-Subacromial spurs
-Type 2 and type 3 acromions
-Osteoarthritic spurs of acromioclavicular joint (includes subacromial
spurs)
-Thickened or calcified coracoacromial ligament
-Nonoutlet impingement
-Loss of rotator cuff causing superior migration of humerus (tear, loss of
strength)
-Secondary impingement from unstable shoulder
-Acromial defects (os acromiale)
-Anterior or posterior capsular contractures (adhesive capsulitis)
-Thick subacromial bursa

I hope this have helped shed some light on how and what tests are used to determine if you have shoulder impingement. As always, feel free to contact me if you have questions.