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Subacromial impingement is not free of criticism. First, the identification of acromion type shows poor intra- and inter-observer reliability. [26] [27] Second, a computerized three-dimensional study failed to support impingement by any portion of the acromion on the rotator cuff tendons in different shoulder positions. [28]
When performing the Neer impingement test, the elbow should be extended, humerus in internal rotation and the forearm pronated. When the examiner is passively flexing the arm forward, it is causing compression of the structures between the greater tuberosity, inferior acromion process and the acromioclavicular joint. [1]
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A torn rotator cuff can occur following trauma to the shoulder or it can occur through the "wear and tear" on tendons, most commonly the supraspinatus tendon found under the acromion. Rotator cuff injuries are commonly associated with motions that require repeated overhead motions or forceful pulling motions.
The acromion is a bony process at the end of the scapula. The shoulder is a complex mechanism involving bones, ligaments, joints, muscles, and tendons. The two main causes are acute injury or chronic and cumulative degeneration of the shoulder joint. Mechanisms can be extrinsic, intrinsic or a combination of both. [27]
For type I and II treatment is usually with a sling and pain medications for a week or two. [2] In type III injuries surgery is generally only done if symptoms remain following treatment without surgery. [2] A separated shoulder is a common injury among those involved in sports, especially contact sports. [3]
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It is attached, by its apex, to the summit of the acromion just in front of the articular surface for the clavicle; and by its broad base to the whole length of the lateral border of the coracoid process. [2] This ligament, together with the coracoid process and the acromion, forms a vault for the protection of the head of the humerus.