SHOULDER IMPINGEMENT SYNDROME
Cause, symptoms and treatment
What is shoulder impingement syndrome?
Shoulder problems can significantly affect a patient's ability to work and other daily activities of daily life such as driving, dressing, brushing hair, and even eating.
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Shoulder impingement syndrome is caused by pinching of the supraspinatus tendon (at the top of the rotator cuff) and bursa (lubricating sac) between the upper arm bone (humerus) and the acromion, the bony arch which is part of the scapula (shoulder blade) that forms the roof of the shoulder. The bursa functions as a cushion and low friction surface which allows the rotator cuff tendons to slide smoothly under the acromion.
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SYMPTOMS:
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Symptoms include pain at the front and/or outside of the shoulder and upper arm, and pain at night when sleeping on the affected side. Pain can often be brought on by lifting or elevating the arm, known as a painful arc. People sometimes describe a sharp pain brought on by reaching into their back pocket or above their heads.
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CAUSES & PREDISPOSING FACTORS:
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Insufficient space between the acromion and the rotator cuff can cause impingement. Normally, the rotator cuff tendons can easily slide under the acromion each time your arm is raised; however, it is normal to have some degree of rubbing or pinching of the tendons and bursa. Overuse of the shoulder in an elevated position can cause the impingement to become a problem and can lead to ongoing pain or damage to the rotator cuff tendons.
Bony spurs on the undersurface of the acromion can contribute to an impingement syndrome, and the inflammation associated with a rotator cuff tear can also cause impingement pain. Poor posture and tight anterior chest wall muscles (pectoral muscles) can also contribute to an impingement syndrome.
TREATMENT:
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Rest from the aggravating activities, anti-inflammatory medicines and soft tissue therapy physical therapy are the mainstay of treatment. In particular, improving overall posture, as well as the position and stability of the shoulder blade is important as this will open up the space between the acromion and reduce the change of impingement. Corticosteroid injections or surgery may be needed in severe cases.
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MYOTHERAPY | Soft tissue therapy:
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Applying various Myotherapy soft tissue therapy techniques to the musculature and tendons of the shoulder girdle can assist in easing inflammatory response, treating over active muscle and tensile tissues. Applying taping to the glenohumeral joint can assist with supporting the joint with correct posture. Dry needling and myofascial cupping can also be incorporated to treat the area.
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Our Myotherapists can assess and treatment Shoulder Impingement Syndrome and related musculoskeletal conditions. Book your initial Myotherapy Consultation and treatment online or phone 03 90422053
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CORRECTIVE EXERCISE:
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Try the following exercises at home to asses in alleviating pain symptoms. Should pain persist contact your Myotherapist, or book your Initial Clinical Pilates assessment.
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Clinical Pilates can assist in strengthening intrinsic muscles of the shoulder and rotator cuff to support correct posture and improve quality of movement.
Retraction
Retract shoulder blades in a downward "V" motion.
Repeat 20 reps
Shoulder Shrugs
Elevate Shoulders up toward ceiling, inhale to hold for 1 count, exhale to draw shoulders down. Repeat 20 reps
Pec Stretch
Lay on floor on a rolled up towel or foam roller in line with your spine, heels hip width apart and hands by your side with palms facing ceiling. Inhale to feel your collar bones lengthen, retracting shoulders. Exhale to relax. Hold for 30-60 seconds.
REFERENCES
1. Patient. Shoulder Pain. Updated June 2015. http://patient.info/doctor/shoulder-pain (accessed Nov 2015).
2. Cleveland Clinic. Impingement Syndrome. Updated May 2014. https://my.clevelandclinic.org/services/orthopaedics-rheumatology/diseases-conditions/hic-impingement-syndrome-of-the-shoulder (accessed Nov 2015).