Which of the following is least likely to contribute to shoulder impingement?

• A. Poor posture
• B. Repetitive overhead movements
• C. Muscle imbalances
• D. Distal radius fracture

Answer: (D)

Shoulder impingement happens when the space under the acromion becomes crowded as the arm lifts, leading to pinching of the rotator cuff tendons and bursa. Factors that disturb shoulder mechanics—poor posture that forwardly tilts the scapula, repetitive overhead movements, and muscle imbalances that alter the balance and timing of the rotator cuff and scapular stabilizers—directly narrow that subacromial space or change how the humeral head moves. A distal radius fracture, which is a wrist injury, doesn’t directly affect the mechanics of the shoulder or the subacromial space, so it’s unlikely to contribute to impingement. So among the options, the wrist fracture is the least related to the development of shoulder impingement.