Impingement with Incomplete tear of Rotator Cuff

1. Subacromial Impingement

    Intrinsic - Degneration tendinopathy

    Extrinsic - Due to coracoacromial arch



Acromion types

Type I - Acromion flat

        II - Curved

       III - Hooked

Types ; Neer Calssification

Stage1 - Edema and haemorrhage ; < 25 years

         2- fibrosis ; 25-40 years

          3 - tendon rupture > 40 years


Treatment

    Antiinflammation

   Steroids

   PT

   Strengthening exercises

 


2. Subcoracoid Impingement

   contact between subscapularis and coracoid

   Treatment - Arthroscopic or open coracoplasty



3. Internal Impingement

 contact of posterior rotator cuff with posterosuperior glenoid when ar mabducted extended and   

  externally rotated.


 Treatment

      PT - Rotator cuff strengthening exercises

      Surgery -  Removal of posterosuperior glenoid osteophytes and posterior release