Shoulder impingement syndrome occurs as the result of chronic and repetitive compression or “impingement” of the rotator-cuff tendons in the shoulder, causing pain and movement problems. It can also be caused by an injury to the shoulder. People who perform repetitive or overhead arm movements, such as manual laborers or athletes who raise their arms repeatedly overhead (ie, weightlifters and baseball pitchers), are most at risk for developing a shoulder impingement. Poor posture can also contribute to its development. If left untreated, a shoulder impingement can lead to more serious conditions, such as a rotator cuff tear. Physical therapists can help decrease pain, and improve shoulder motion and strength in people with shoulder impingements.
What is Shoulder Impingement?
- Repetitive overhead movements, such as golfing, throwing, racquet sports, and swimming, or frequent overhead reaching or lifting.
- Injury, such as a fall, where the shoulder gets compressed.
- Bony abnormalities of the acromion, which narrow the subacromial space.
- Osteoarthritis in the shoulder region.
- Poor rotator cuff and shoulder blade muscle strength, causing the humeral head to move abnormally.
- Thickening of the bursa.
- Thickening of the ligaments in the area.
- Tightness of the soft tissue around the shoulder joint called the joint capsule.
How Does Shoulder Impingement Feel?
- Restriction in shoulder motion with associated weakness in movement patterns, such as reaching overhead, behind the body, or out to the side.
- Pain in the shoulder when moving the arm overhead, out to the side, and beside the body.
- Pain and discomfort when attempting to sleep on the involved side.
- Pain with throwing motions and other dynamic movement patterns.
How Is Shoulder Impingement Diagnosed?
How Can a Physical Therapist Help Treat Shoulder Impingement?
Range-of-Motion Exercises. You will learn exercises and stretches to help your shoulder and shoulder blade move properly, so you can return to reaching and lifting without pain.
Strengthening Exercises. Your physical therapist will determine which strengthening exercises are right for you, depending on your specific condition. Often with shoulder impingement syndrome, the head of the humerus tends to drift forward and upward due to the rotator-cuff muscles becoming weak. Strengthening the rotator-cuff and scapular muscles helps position the head of the humerus bone down and back to ease the impingement. You may also perform resistance training exercises to strengthen your weaker muscles. You will receive a home-exercise program to continue your strengthening long after you have completed your formal physical therapy.
Patient Education. Learning proper posture is an important part of rehabilitation. For example, when your shoulders roll forward as you lean over a computer, the tendons in the front of the shoulder can become impinged. Your physical therapist will work with you to help improve your posture, and may suggest adjustments to your work station and work habits.
Functional Training. As your symptoms improve, your physical therapist will teach you how to correctly perform a range of functions using proper shoulder mechanics, such as lifting an object onto a shelf or throwing a ball. This training will help you return to pain-free function on the job, at home, and when playing sports.
Can Shoulder Impingement be Prevented?
- Maintaining proper strength in the shoulder and shoulder-blade muscles.
- Regularly stretching the shoulders, neck, and middle-back region.
- Maintaining proper posture and shoulder alignment when performing reaching and throwing motions.
- Avoiding forward-head and rounded-shoulder postures (being hunched over) when spending long periods of time sitting at a desk or computer.
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