Shoulder Impingement
With over 16 muscles attaching to the scapula the shoulder is the most complicated joint within the body and when experiencing shoulder pain if it’s not that there is a specific injury, it is very often a case of poor posture and very imbalanced muscles.
Shoulder impingement is pain when lifting the arm to shoulder height and often people will not be able to reach above this point, scratch their back or abduct the arm.
The problem is caused when the sub-acromial space within the shoulder is impinged or restricted by something, commonly one of the rotator muscles (supraspinatus, subscapularis, teres minor and infraspinatus)
Although this is not serious, if left untreated the tendons of the rotator cuff may thicken over time, reducing the sub-acromial space and making pain chronic.
Shoulder impingement can take 6 months to a year to completely rehab if the issue appears to be chronic and developed over years and years of moving incorrectly.
Symptoms:
Pain when raising the arm
Pain in muscle testing
Pain when palpating anterior shoulder
Obviously poor posture
Muscle wastage around that arm
Ranges are limited
Protecting the arm and not wanting to move it
Sudden pain when moving
Pain when sleeping on that side
Cause:
Bone spurs
Rotator cuff tear
Labral injury
Shoulder instability
Bicep tendinopathy
Scapula dysfunction
Poor Posture
Tight/ weak muscles being over powered
Incorrect muscle engagement over time
Treatment:
It is important when we diagnose an impinging shoulder that we work out why you have the problem. There are many tests a physiotherapist or sports therapist can use to diagnose the cause of the problem.
Acute injury stages are important to treat the initial pain and seek to make you more comfortable (Ice, rest, strapping, Medication)
Sports massage to help lengthen or break down tight tissue, also using passive movements to help increase the sub-acromial space.
Improve and maintain the mobility of the shoulder with stretching and passive movements.
A specific strengthening plan will also be important when all pain has reduced and range of movement has started to improve within the joint.
Hydrotherapy can be a great way to help strengthen the joint up without taking full weight of the arm.
If through scans and diagnosis it is clear there Is a buildup of scar tissue, or something that cannot be treated via remedial methods the below actions can be taken.
Injections into the joint
Surgery
