Have you ever tried stretching for a mug on a high kitchen shelf, only to feel a sudden, sharp pain shoot through your shoulder? This could be shoulder impingement, a common condition that occurs when the tissues in your shoulder joint get pinched¹. It happens when the space between your shoulder blade (acromion) and the top of your upper arm bone (humerus) narrows, causing irritation and inflammation of the tendons and bursa (fluid-filled sac) that cushion the rotator cuff muscles, responsible for shoulder movement.
If this sounds like something you are suffering from, here are some effective ways to manage this condition with shoulder physiotherapy and get you back to living your life pain-free.
1. Causes of Shoulder Impingement
Before we delve deeper into the treatment options for shoulder impingement, let’s first understand what causes it. Some common culprits include:
- Repetitive overhead motions: Activities like painting, throwing, or weightlifting that involve frequent overhead arm movements can overuse the muscles and tendons, leading to irritation.
- Poor posture: Slouching or hunching can compress the space in your shoulder joint, increasing the risk of impingement.
- Muscle imbalances: Weakness in certain shoulder muscles can place undue stress on others, which can directly be the cause of imbalances and impingement.
- Age-related wear and tear: Over time, the tendons in your shoulder naturally lose some elasticity, making them more prone to impingement.
2. Symptoms and Diagnosis
Shoulder impingement can manifest in several ways. Here are some telltale signs:
- Pain in the front or side of the shoulder, especially when reaching overhead or behind the back.
- Weakness in the shoulder, making it difficult to lift objects.
- Difficulty sleeping on the affected side.
- Aching or catching sensation in the shoulder with movement.
- Reduced range of motion in the shoulder joint.
If you are experiencing these symptoms, it’s crucial to consult a physiotherapist for a proper diagnosis. They will typically perform a physical examination and assess your range of motion, strength and tenderness in the muscles and tendons. In some cases, imaging tests like X-rays or MRIs may be needed to rule out other causes of shoulder pain, such as fractures or arthritis.
3. Physiotherapy Rehabilitation Techniques
Physiotherapy offers a personalised approach to treating shoulder impingement, focusing on pain relief, improving mobility, and strengthening the muscles². Here are some techniques we use at The Movement Laboratory to help patients achieve relief.
- Manual therapy: Through massage and joint mobilisation techniques, we improve flexibility, decrease muscle tension, and promote proper joint alignment in your affected shoulders.
- Strengthening exercises: Targeted exercises will focus on strengthening the rotator cuff muscles (which stabilise the shoulder joint) and the scapular muscles (which support proper shoulder blade movement). Examples include:
-
- External rotations with a resistance band:
Attach a resistance band to a fixed object at waist height. Stand sideways to the anchor point, hold the band with the hand farthest from the anchor, and bend your elbow to 90 degrees. Keeping your elbow close to your body, rotate your arm outward. Perform 10-15 repetitions on each side.
-
- Internal rotations with a resistance band:
Attach a resistance band to a fixed object at waist height. Stand sideways to the anchor point, hold the band with the hand closest to the anchor, and bend your elbow to 90 degrees. Keeping your elbow close to your body, rotate your arm inward. Perform 10-15 repetitions on each side.
-
- Scapular Push-Ups:
Get into a plank position with your hands directly under your shoulders. Without bending your elbows, squeeze your shoulder blades together, then push them apart. Perform 10-15 repetitions.
- Stretching exercises: Gentle stretches such as cross-body shoulder stretch, doorway stretch, and overhead triceps stretch will help improve flexibility in the shoulder capsule and surrounding muscles, allowing for a wider range of pain-free movement.
-
- Cross-body shoulder stretch:
Bring one arm across your body at chest level and use your other hand to gently pull the arm closer to your chest. Hold for 15-30 seconds and repeat on the other side.
-
- Doorway stretch:
Source: Rehabpro
Stand in a doorway with your arms out to the sides, elbows bent at 90 degrees, and hands gripping the door frame. Lean forward gently to stretch your chest and shoulders. Hold for 15-30 seconds.
-
- Overhead triceps stretch:
Raise one arm overhead, bend the elbow to bring your hand down toward the opposite shoulder blade, and use your other hand to gently push the elbow down. Hold for 15-30 seconds and repeat on the other side.
4. Preventive Measures
Beyond physiotherapy, your daily activities play an equally vital role in maintaining long-term shoulder health. Here are some preventive measures you can take:
- Maintain good posture: Sit up straight with your shoulders back and relaxed, and avoid slouching.
- Warm up before exercise: Perform dynamic stretches and light cardio to prepare your shoulders for activity.
- Cool down after exercise: Static stretches after exercise can help maintain flexibility and prevent tightness.
- Strengthen your core: A strong core helps stabilise your body and reduces stress on your shoulders.
- Maintain a healthy weight: Excess weight can put additional strain on your joints, including your shoulders.
- Listen to your body: Pain is a signal that something’s wrong. Take breaks during activities and avoid pushing through pain.
- Modify your activities: If certain activities aggravate your shoulders, modify them or find alternative exercises.
Shoulder impingement can be a frustrating limitation, but with shoulder rehab, you can find relief and regain full function in your shoulder³. Remember, early diagnosis and treatment are key to a full recovery from this condition.
Don’t hesitate to contact The Movement Laboratory for a consultation. Our qualified physiotherapist will be more than happy to help you get back to the activities you love without discomfort and pain.
References
- Garving, C., Jakob, S., Bauer, I., Nadjar, R., & Brunner, U. H. (2017). Impingement Syndrome of the Shoulder. Deutsches ÄRzteblatt International, 114(45), 765-776. https://doi.org/10.3238/arztebl.2017.0765
- Hanratty, C. E., McVeigh, J. G., Kerr, D. P., Basford, J. R., Finch, M. B., Pendleton, A., & Sim, J. (2012). The effectiveness of physiotherapy exercises in subacromial impingement syndrome: a systematic review and meta-analysis. Seminars in arthritis and rheumatism, 42(3), 297–316. https://doi.org/10.1016/j.semarthrit.2012.03.015
- Dickens, V. A., Williams, J. L., & Bhamra, M. S. (2005). Role of physiotherapy in the treatment of subacromial impingement syndrome: A prospective study. Physiotherapy, 91(3), 159-164. https://doi.org/10.1016/j.physio.2004.10.008