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Anatomical and biomechanical

mechanisms of subacromial
impingement syndrome
ScienceDirect
Lori A. Michener a, , Philip W. McClure bAndrew R. Karduna c

Copyright 2003 Elsevier Science Ltd. All rights reserved.

Review paper

aDepartment of Physical Therapy, Medical College of

Virginia, Virginia Commonwealth University, P.O. Box
980224, Richmond, VA 23298, USA
bDepartment of Physical Therapy, Arcadia University,
Glenside, PA, USA
cDepartment of Exercise and Movement Science,
University of Oregon, Eugene, OR, USA

Received 26 February 2003. Accepted 27 February 2003.

Available online 8 April 2003.

Abstract
Subacromial impingement syndrome is the most common
disorder of the shoulder, resulting in functional loss and
disability in the patients that it aects. This musculoskeletal
disorder aects the structures of the subacromial space,
which are the tendons of the rotator cu and the
subacromial bursa. Subacromial impingement syndrome
appears to result from a variety of factors. Evidence exists
to support the presence of the anatomical factors of
inammation of the tendons and bursa, degeneration of the
tendons, weak or dysfunctional rotator cu musculature,
weak or dysfunctional scapular musculature, posterior
glenohumeral capsule tightness, postural dysfunctions of
the spinal column and scapula and bony or soft tissue
abnormalities of the borders of the subacromial outlet.
These entities may lead to or cause dysfunctional
glenohumeral and scapulothoracic movement patterns.
These various mechanisms, singularly or in combination
may cause subacromial impingement syndrome.

Keywords
Subacromial impingement syndrome
Shoulder
Review