Rehabilitation & Physical Therapy Articles

Everything You Need to Know About Shoulder Impingement
by Edward Aube

Does your shoulder hurt when you reach above your head, throw a ball, reach behind your back, or have difficulty sleeping on your side? If it does, you may be suffering from shoulder impingement.

Shoulder impingement occurs when the tendons of your rotator cuff muscles become pinched between your arm bone and shoulder blade as you move your shoulder. The rotator cuff is a group of four muscles, the supraspinatus, infraspinatus, subscapularis, and teres minor that function to stabilize the shoulder as the arm moves. When their tendons are pinched they become inflamed, causing pain, and stiffness. Unfortunately, this process also leads to weakness, in turn causing more pinching and inflammation. This cycle continues which makes shoulder impingement a problem that typically does not go away with just rest.

To break the cycle, the inflammation and swelling need to be reduced to limit further impingement and promote the healing process. Ice, gentle pain free exercises, and limitation of overhead or painful activities are a must in starting the recovery process. Occasionally, injections of anti-inflammatories can be used to reduce severe or stubborn inflammation.

Once the process is begun, strengthening of the rotator cuff and shoulder girdle exercise can be started to regain strength stabilization and proper movement of the shoulder and arm. Stretching exercises will also need to be performed to regain flexibility of the shoulder joint capsule, and shoulder musculature, which may have become tight due to lack of use.

If inflammation is not reduced, and the arm is continued to be used the tendons can become so worn that a tear of the cuff may develop. A tear can also occur over a short period of time during a fall, or other traumatic event. A rupture of your biceps muscle, at its attachment near the shoulder, is also a common result of leaving your shoulder impingement syndrome untreated.

Mild cases of impingement can be treated with just ice and anti-inflammatories. However, if tenderness and pain with movement are not relieved with these simple steps, then professional help is necessary.

Physical Therapists are specially trained in evaluating and treating shoulder impingement. In most states you can consult a physical therapist directly, without a referral from your physician. Through their examination, they can determine the right course of action to restore pain free function through inflammation reducing modalities, along with the correct combination of strengthening and stretching exercises. They can also help determine whether the condition requires referral for problems which might not be alleviated through therapy.

In those instances, an orthopedic surgeon would likely be the specialist to see. X-rays, Magnetic Resonance Imaging(MRI) or CT scans might be performed to clearly identify the pathology causing shoulder pain.

It is important to never begin taking daily medication without consulting your doctor. If you do feel that you may have shoulder impingement syndrome, as you can see, it’s easily treated. However, putting off treatment can cause more severe problems so do not hesitate to call a Cleveland physical therapist for a consultation as soon as possible.