Shoulder Impingement
What is shoulder impingement?
•Shoulder impingement is a common cause of shoulder pain located on the front/head of your shoulder.
•It’s also known as impingement syndrome. It’s common in athletes who use their shoulders a lot, like baseball & softball players, swimmers and volleyball players.
•Certain occupations that require lots of heavy lifting or overhead arm movement also are at increased risk.
Your rotator cuff is a group of muscles and tendons that attach your upper arm bone to your shoulder. It helps you lift your arm overhead and rotate your arm.
The rotator cuff sits under the top of the shoulder. If you have shoulder impingement, your rotator cuff is catching or rubs between the two bones articulating in the shoulder joint.
When you lift your arm, the space (bursa) between the rotator cuff and the bone narrows, which increases pressure.
The increased pressure irritates the rotator cuff, leading to impingement.
What are the symptoms?
The main symptom of shoulder impingement is sudden pain in your shoulder when you lift your arm overhead or backward.
Other symptoms include:
• minor to moderate, constant pain in your arm
• pain that goes from the front of your shoulder to the side of your arm
• pain that gets worse at night, especially when sleeping on the side of impingement
• shoulder or arm weakness
What causes it?
Many cases of shoulder impingement are caused by overuse injuries.
Repeated use of the shoulder in awkward positions, such as when stabilizing something overhead, can make the tendons in your shoulder swell, leading them to “catch” on your upper shoulder bone.
Also traumatic onset and poor posture are leading culprits.
Who’s at risk of having it?
Historically, age, overuse & previous shoulder injuries are the major risk factors in the development of impingement syndrome.
However, it is becoming increasingly more common that people sitting at desk jobs are becoming an at risk population for shoulder impingement because of repetitive poor posture.
Slouching, hunching, sliding down when seated and other seemingly harmless positions ultimately contribute to pinching and shoulder impingement syndrome over time.
How is it diagnosed?
Your doctor will start by taking a history of the injury & ask questions about any previous injuries, as well as exercise habits. Next, they will examine your shoulder and may ask you to do a series of motions while they check for any unusual movement in your shoulder. This will help your doctor rule out other conditions, such as nerve impingement or soft tissue tears.
In some cases, your doctor may recommend an x-ray to rule out arthritis or bone spurs that could lead to impingement or an MRI scan if your doctor thinks it’s a more serious rotator cuff injury.
How is it treated?
There are many types of treatment available for shoulder impingement, depending on how serious your injury is. These therapies range from at non-invasive at home treatment to surgery.
MILD CASES
For the least severe cases a home care regimen of rest, ice, anti inflammatory medications and stretching exercises should decrease the inflammation and pain, returning you to your normal lifestyle.
MODERATE TO SEVERE CASES
Chiropractic Treatments - aimed at getting the shoulder blade, spine and ribs moving properly again.
Active Release Therapy (ART) - to break down scar tissue and recondition the muscles which comprise the rotator cuff so they can decrease swelling and tension.
Corrective Exercises - to strengthen and retrain the shoulder blade to assume the normal, controlled, scapular movements.
SERIOUS CASES
A chronic tear may require surgical repair.
More about ART …
Active Release Therapy is a soft-tissue movement based massage technique utilized by some chiropractors to work directly with muscles, tendons, ligaments, and fascia. It helps to relieve tight muscles and nerve trigger points greatly reducing joint stress and muscle pain.
