A Physical Therapist's Guide to Shoulder Impingement
According to the American Physical Therapy Association, shoulder impingement syndrome occurs because of repetitive or chronic compression of the rotator-cuff tendons in the shoulder, which can lead to pain and movement problems.
Sometimes, impingement syndrome can be directly caused by an injury to the shoulder itself.
Who is most at risk for developing a shoulder impingement? Primarily, it happens more in athletes who do repeated overhead arm movements.
Likewise, people who perform repetitive tasks could suffer the worst. Similarly, poor posture might contribute to its development.
If it's not treated correctly, a shoulder impingement might lead to more serious problems, including a rotator-cuff tear.
Typically, a physical therapist can help decrease pain. However, they also provide exercises to improve the physical condition of people with shoulder impingement.
Likewise, a physical therapist offers assistance to help improve shoulder motion and strength in people who are suffering.
Though this problem occurs as the result of repetitive compression in the bony acromion and the rotator cuff, there are things you can do to protect yourself. Let's learn more in this comprehensive guide.
What Is Shoulder Impingement Syndrome?
Generally, shoulder impingement syndrome is a condition that develops whenever the rotator-cuff tendons in the shoulder are injured or overused. This leads to movement impairments and pain.
Sometimes, shoulder impingement syndrome may also be called "subacromial impingement syndrome" because the bursa, ligaments, and tendons underneath the acromion become compressed or pinched.
Primarily, the shoulder is made up of three bones: the clavicle, the scapula, and the humerus. The acromion is the bony prominence atop the scapula, which is often considered a bump at the tip of the shoulder.
Your bursa and rotator-cuff tendon sit under the acromion. Overall, your bursa is the fluid-filled sac that offers a cushion between the other parts, so it can easily get compressed and cause pain.
In a sense, the cushion between the bony acromion can dissipate, especially when there is compression. Impingement symptoms can then occur, which harms the tendons as they deal with microtrauma.
There are many causes of shoulder impingement syndrome, which include:
- Tightness in the soft tissue around your shoulder joint (joint capsule)
- Thickening of the shoulder ligaments
- Thickening of the bursa
- Poor shoulder blade and rotator-cuff strength
- Osteoarthritis in the shoulder area
- Bony abnormalities in the acromion
- Injury where the shoulder is compressed
- Repetitive overhead movements (golfing, racquetball, swimming, throwing sports, and more)
How Does a Shoulder Impingement Feel?
Those with a shoulder impingement might experience:
- Pain with dynamic movement patterns or throwing motions
- Discomfort or pain when sleeping on that side
- Pain in the shoulder when moving the arm beside the body, out to the side, or overhead
- Restriction in shoulder motion, making it harder to move the arm out to the side, behind the body, or overhead
How Is Shoulder Impingement Syndrome Diagnosed?
Typically, a physical therapist will perform an exam and ask questions about your symptoms and pain. They might also complete motion and strength tests on the shoulder, evaluate your posture, determine your hobbies and job duties, and check for weaknesses or imbalances within the muscles.
Special testing might be required for diagnosis and treatment, though they will discuss these with you. For example, some physical therapists use dry needling, while others focus on manual therapy and exercise.
How Might a Physical Therapist Help You?
Overall, it is crucial to get proper treatment for shoulder impingement. Do this as soon as it occurs. If you don't, secondary conditions can result, such as tears, rotator-cuff tendinitis, and irritation of the bursa.
Physical therapy for shoulder pain can be successful when treating this condition. The physical therapist will design a program to help you. It will be specific to your condition and goals.
Because shoulder impingement syndrome can have different issues relating to it, a professional must devise a treatment plan that is specific to your needs.
Your treatment program may include these options:
Manual Therapy
Typically, the physical therapist may use manual techniques, including shoulder stretches, soft-tissue massages, and gentle joint movements. While these can cause pain, they will help you improve later on.
Traditionally, a physical exam is required before any physical therapy treatment is done. This will determine your specific issues and help the team focus on the right plan.
Shoulder Pain Management
The physical therapist will help you avoid any painful movements and identify them. Plus, they can correct poor posture to reduce compression.
One physical therapy modality is iontophoresis, which is a medication that's delivered through a special patch. Another option is ultrasound therapy.
Ice is often used to reduce pain after exercising the area.
Strengthening Exercise Options
In most cases, physical therapy requires the professional to find out which strengthening exercises are right for your needs.
Often, when you're dealing with shoulder impingement syndrome, the humerus head drifts upward and forward because the rotator-cuff muscles are weak. Strengthening them with an appropriate exercise routine will ease the pain.
Sometimes, therapists will have you perform resistance exercise routines to strengthen the muscles. This can also reduce rotator-cuff pain.
Building strength in people with shoulder impingements is often the first step. You will likely get a home exercise routine to continue doing after physical therapy has ended.
Range-of-motion Exercise
Generally, you will learn about exercise and stretch options that will improve your range of motion in the shoulder blade, allowing it to move properly.
These exercises may include stretches, shoulder blade squeezes, and arm rotations. It's all part of the physical therapy treatment plan.
Functional Training
The goal of physical therapy is to improve your symptoms. This will happen in time, but you'll have to learn how to perform different functions using proper shoulder mechanics. Those include throwing balls and lifting objects overhead.
Your physical therapist will teach you how to do those things. In fact, the training is designed to ensure you can perform routine functions at home, on the job, and when playing sports without pain.
Likewise, your therapist may teach specific things that relate to your job or requirements.
Patient Education
One part of physical therapy and rehabilitation is to learn proper posture. Your physical therapist will work with you to prevent your shoulders from rolling forward while working on a computer.
Similarly, your physical therapist will also suggest various adjustments you can make to your work habits and workspace if needed.
Ultimately, the first step is to improve your range of motion. Then, the physical therapist will educate you on the best ways to do your work each day.
Can Shoulder Impingement Syndrome Be Prevented?
Yes, shoulder impingement syndrome can be prevented by:
- Not using forward-head and rounded-shoulder postures when sitting at a computer/desk for long periods
- Maintaining the right shoulder alignment and posture when throwing or reaching for something
- Regularly performing exercise routines that stretch and strengthen the middle back, neck, and shoulders
Where to Get Physical Therapy for Shoulder Impingement
As you've learned, physical therapy often includes exercises to help improve your range of motion and build strength. If you have a shoulder impingement, it's crucial to work with a therapist who understands your issue.
Book an appointment with ProTouch Physical Therapy today to begin developing a treatment plan that will help.
