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AFI impingement, also known as anteroinferior impingement, is a condition that affects the shoulder joint, particularly the rotator cuff tendons and the biceps tendon. It occurs when there is abnormal contact between the rotator cuff tendons and the undersurface of the acromion bone and/or the coracoacromial ligament, leading to pain, inflammation, and restricted movement in the shoulder.
External impingement: This occurs when the rotator cuff tendons become pinched between the humeral head (upper arm bone) and the acromion/coracoacromial ligament during certain shoulder movements, such as reaching overhead or lifting objects. External impingement is commonly associated with repetitive overhead activities and can lead to irritation and inflammation of the rotator cuff tendons.
Internal impingement: This occurs when the rotator cuff tendons and the biceps tendon become pinched between the humeral head and the glenoid (shoulder socket) during certain positions or movements of the shoulder joint, particularly during throwing or overhead sports. Internal impingement is commonly seen in athletes involved in overhead sports such as baseball, tennis, or volleyball and can lead to pain, instability, and decreased performance.
Treatment for AFI impingement typically begins with conservative measures such as rest, activity modification, physical therapy, anti-inflammatory medications, and corticosteroid injections to reduce pain and inflammation. In cases where conservative treatments fail to provide relief, or for severe or persistent symptoms, surgical intervention may be necessary to address the underlying structural issues causing impingement. Surgical options may include arthroscopic subacromial decompression, biceps tenodesis, or repair of associated rotator cuff tears. The specific treatment approach will depend on the severity and cause of impingement, as well as individual factors such as age, activity level, and overall health.