Shoulder Impingement Syndrome

Impingement Syndrome, which is sometimes called Swimmer’s shoulder or Thrower’s shoulder, is caused by the tendons of the rotator cuff (supraspinatus, infraspinatus, teres minor and subscapularis muscles) becoming ‘impinged’ as they pass through a narrow bony space called the subacromial space – so called because it is under the arch of the acromium which is a part of the shoulder blade. With repetitive pinching, the tendon(s) become irritated and inflamed. There are other structures that can cause this so come in for a check to see what the problem is.


  • Shoulder pain that gradually comes on over time
  • Pain at the front/side of the shoulder when lifting the arm above head height
  • Pain at the back and/or front of the shoulder when the arm is held out to the side (abducted) and turned outwards (external rotation)

Article on Impingement Syndromes from ‘Shoulder Solutions’

Rib lesion/subluxation

When playing contact sports it is common for ribs to subluxate which is where they come out slightly and do not return to their normal anatomical position. Local ligament and soft tissue damage can occur.


  • Local pain and tenderness at the rib head which is just off to one side of the spine
  • Pain when taking a deep breathe in
  • Pain when pressure is placed over that side of the rib cage

Rotator Cuff Muscle Strain

These are a group of muscles that help to stabilise the glenohumeral joint (shoulder joint) whilst also rotating it. The muscles that make up the
rotator cuff are; supraspinatus, infraspinatus, teres minor and subscapularis. Supraspinatus and infraspinatus are most commonly injured due to their action of providing a lot of shoulder rotation. With rotator cuff injuries either the muscle/tendon can be damaged or inflammation around these can cause impingement (pinching) of surrounding structures.


  • Acute
  • Pain and tearing feeling giving severe pain
  • Painful raising arm out to the side
  • Very pin point pain
  • Chronic
  • Usually found on dominant side
  • 40+ usually with gradual onset of pain and some weakness
  • Difficult to raise arm in most ranges of movement
  • Can lead to impingement syndromes

Article of rotator cuff injuries from ‘EMedicine’

AC Joint Injury/Separation

The AC joint is where the acromium (part of the shoulder blade) joins the clavicle (collar bone) and is usually the highest part of the shoulder.
Separation of these two bones is due to ligament damage. Most common onset of the pain is falling either onto the shoulder itself or onto an outstretched arm. There are grades from 1-6 for AC separation so you should get it checked out to see how bad the damage is.


  • Pain over the tip of the shoulder; at first the pain is diffuse but later becomes very focal.
  • A ‘step deformity’ may be visible; it is seen as a raised lump on the shoulder
  • Pain when raising the shoulder above shoulder height

Article about AC Joint Separation from ‘AboutOrthopedics’

Hamstring Strain

The hamstring muscles (group of 3) run from the back of the knee up to the bottom of your pelvis. The muscles assist in many movements but their main action is to bend the knee, pulling the heel towards the bottom. They are commonly shortened through a lack of stretching both before and/or after exercise. They can be damaged through over-stretching or over use whilst playing sport or in the gym.


  • Change to gait
  • Tenderness and pain – especially whilst stretching
  • Feeling that ‘it’s going to go’ where the muscle strain has occurred

Article from ‘DrFoot’

Anterior Cruciate Ligament Tear

The anterior cruciate ligament runs from the back of the femur (thigh bone) diagonally down to the front of the tibia (shin bone). Its role is to stop the tibia sliding forward away from the femur when a force is placed from below it. It is commonly caused by a twisting movement being placed through the knee whilst the foot is planted. It can also occur from a tackle.


  • Instability and swelling
  • Restricted range of movement especially in straightening the knee
  • Pain felt can be very high – especially straight after the injury

Article from ‘’

Medial Collateral Ligament Tear

Your medial collateral ligament (MCL) runs along the inside of your knee and joins your femur (thigh bone) to your tibia (shin bone). It is usually damaged when a force is placed on the outside of the knee going across the knee. This causes a gapping of the knee and, if the force is great enough, a partial or complete tear of the MCL. The grade of injury (as with all ligament damage) can vary from grade 1 to 3. Grade 1 is classed as 10% of fibres are torn and Grade 3 is a complete tear. Grade 2 falls inbetween meaning the symptoms can sometimes vary.


  • Tenderness over inside of the knee
  • Some swelling around the area
  • When gapping the knee there is joint laxity – gives the feeling of instability

Article from Orthopaedic Website