For a patient with shoulder impingement, which activity is least advisable?

In the context of shoulder impingement, overhead lifting is considered the least advisable activity. This is because shoulder impingement typically arises from structures in the shoulder, such as tendons and bursa, becoming irritated or compressed during overhead movements. When a patient engages in overhead lifting, it can exacerbate this issue by placing increased stress on the shoulder joint and the surrounding structures.

The mechanics of overhead lifting often involve elevating the arms above shoulder level, which can cause the muscles of the rotator cuff and the subacromial bursa to be compressed against the acromion, leading to pain and potentially worsening the impingement syndrome.

On the other hand, activities such as internal and external rotation, as well as diagonal arm lifts, can be performed with care and proper technique. These movements often focus on improving shoulder stability and range of motion, which can ultimately aid in rehabilitation and recovery from shoulder impingement. They are typically considered less likely to provoke pain and may be beneficial as part of a comprehensive treatment strategy. Therefore, avoiding overhead lifting is crucial for managing shoulder impingement effectively.