It occurs in chronic way, generating restriction in the amplitude of passive movement because of fibrose. A related site: Marc Lore mentions similar findings. The x-rays can show to ostefitos under the acrmio and degenerative alterations in the joint to acromioclavicular. In these cases the treatment conservative can be the sufficient, however a surgical intervention considered can become necessary ‘ ‘ profiltica’ ‘ , therefore it goes to alliviate the painful picture definitively and to prevent the rupture of the manguito that generally occurs with the evolution of the illness. Period of training III – it occurs more frequently in patients with more than 40 years of age, in the image examinations observes it formation of ostefitos and contact of the head of mero with the acrmio, lacerao of partial thickness or, eventually, total thickness of the rotador manguito, with evident consuming of the muscles supply-spinal and infra-spinal. Possibly it can be found in the physical examination, looseness to capsular important, with multidirectional instability. The surgical intervention is indicated, that has as objective the acromioplastia and the reconstruction of rotador manguito. TREATMENT FISIOTERAPUTICO the majority of the cases of the syndrome of the impact can adequately be dealt with functional whitewashing. It is necessary, for in such a way, the accomplishment of a multicriteria evaluation, where it must be investigated the causes of the disfuno mechanics.

The main objectives of the treatment include: the reduction of pain and the inflammation, the reestablishment of the function escapulo-stabilizer, the reestablishment of the normal standards of the glenoumeral and escapulo-torcico movement, the reestablishment of the resistance and the force of the muscles rotadores and the long portion of the biceps, sensrio-motor reorganization and the return to the functional and vigorous activities of the shoulder, occupational and athletical.