Impingment Syndrome


The shoulder joint is the body’s most mobile joint. It can turn in many directions. But, this advantage also makes the shoulder an easy joint to dislocate. A partial dislocation (subluxation) means the head of the upper arm bone (humerus) is partially out of the socket (glenoid). A complete dislocation means it is all the way out of the socket. Both partial and complete dislocation cause pain and unsteadiness in the shoulder.


A shoulder dislocation generally occurs after an injury such as a fall or a sports-related injury. About 95% of the time, when the shoulder dislocates, the top of the humerus is sitting in front of the shoulder blade–an anterior dislocation. In less than 5% of cases, the top of the humerus is behind the shoulder blade–a posterior dislocation. Posterior dislocations are unusual, and seen after injuries such as electrocution or after a seizure.


Patients with a shoulder dislocation are usually in significant pain. They know something is wrong, but may not know they have sustained a shoulder dislocation. Symptoms of shoulder dislocation include:

  • Shoulder pain
  • Arm held at the side, usually slightly away from the body with the forearm turned outward
  • Loss of the normal rounded contour of the deltoid muscle


  •  Significant pain, which can sometimes be felt past the shoulder, along the arm.
  •  Inability to move the arm from its current position, particularly in positions with the arm reaching away from the body and with the top of the arm twisted toward the back.
  •  Numbness of the arm.
  •  Visibly displaced shoulder. Some dislocations result in the shoulder appearing unusually square.


  •  Anterior (forward)

 Over 95% of shoulder dislocation cases are anterior. Most anterior dislocations are sub-coracoid. Sub-glenoid; subclavicular; and, very rarely, intrathoracic orretroperitoneal dislocations may occur

  •  Posterior (backward)

 Posterior dislocations are occasionally due to electrocution or seizure and may be caused by strength imbalance of the rotator cuff muscles. Posterior dislocations often go unnoticed, especially in an elderly patient. An average interval of 1 year was discovered between injury and diagnosis of posterior dislocation in a series of 40 patients.

  •  Inferior (downward)

 Inferior dislocation is the least likely form, occurring in less than 1% of all shoulder dislocation cases. This condition is also called luxatio erecta because the arm appears to be permanently held upward or behind the head. It is caused by a hyper abduction of the arm that forces the humeral head against the acromion. Inferior dislocations have a high complication rate as many vascular, neurological, tendon, and ligament injuries are likely to occur from this kind of dislocation.


Diagnosis of a shoulder dislocation is usually quite apparent just by talking to a patient and examining their joint. Patients must be examined to determine if there is any nerve or blood vessel damage. This should be done prior to reduction (repositioning) of the shoulder dislocation. X-rays should be obtained to check for any fracture around the joint, and to determine the pattern of the shoulder dislocation.


At Physioline, all the members of the rehabilitation team work together so as to provide proper care and the therapy in order to:

  • Pain relief
  • Reduce stiffness
  • Reduce swelling
  • Strengthening of muscle
  • Regain full range of motion
  • Sports specific training

Visit Physioline for the Consultation and treatment