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  • Writer's pictureThitipong

Hand behind back and Shoulder Pain | EP.25

Updated: Apr 21

Movement Limitations in Shoulder Impingement Syndrome


The direction of restricted movement in shoulder impingement syndrome is complex due to the complicated structure of the shoulder joint, which consists of several components arranged in a complex manner, including bones, cartilage, the labrum, ligaments, the joint capsule, tendons, nerves, and muscles. These components connect the arm to the trunk and allow movement of the arm in various directions


When an injury occurs in the shoulder joint, it results in restricted movement in different directions, which is related to the injured structure. For example, when the hand is moved in an internal rotation with an adduction position or when the arm is raised in an external rotation with an abduction position, the height of the hand when it is slid up along the back or the movement of the elbow joint inward and outward can be variables that trigger pain. This is because the coracohumeral ligament on the back and upper part and the axillary pouch, including the inferior glenohumeral ligament, on the front and lower part of the shoulder joint are stretched out in both of these positions. Furthermore, the height of the hand and elbow can also be used to monitor symptoms and assess the range of motion of the shoulder joint.


In the case of shoulder impingement syndrome caused by an inflamed joint capsule, the thickening of the coracohumeral ligament can affect the external rotation of the arm, while the thickening of the axillary pouch can affect the abduction of the arm.


As a result, when the joint capsule is thickened, it can cause movement limitations, pain, and discomfort, and eventually lead to adhesive capsulitis or a frozen shoulder.


I won't stop moving until it's time to rest.

Translated and arranged by

Thitipong, PT



#ฐิติพงศ์คลินิกกายภาพบำบัด #ภูเก็ต

Thitipong Physical Therapy Clinic

Location: 112 Physical Therapy Clinic, Phuket, Thalang, Saku. .






[] Lee, H., Kim, S. Y., & Chae, S. W. (2017). A comparative study of the behaviors of normal and frozen shoulder: A finite element study. International Journal of Precision Engineering and Manufacturing, 18(4), 545-553.

[] Bhatia, D. N., & de Beer, J. F. (2007). The axillary pouch portal: a new posterior portal for visualization and instrumentation in the inferior glenohumeral recess. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 23(11), 1241-e1.

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