Shoulder impingement occurs when the subacromial space is narrowed. The subacromial space is the area below the bony prominence (known as the acromion) at the top of your shoulder. The subacromial space can become narrowed in the presence of swelling and thickening of the rotator cuff muscles, inflammation of the bursa (small fluid filled sack), or migration of the humeral head because of rotator cuff muscle weakness or imbalance. It can also occur in individuals who have a natural hook-shape to their acromion. With repeated impingement, the rotator cuff muscle tendons can calcify and eventually tear.
Shoulder impingement syndrome is often associated with pain and weakness when lifting your arm overhead. This can be caused by a sudden injury or a more gradual onset. I often treat athletes involved in sports with a lot of overhead movements and these individuals are particularly susceptible to developing shoulder impingement pain, as well as individuals who perform repetitive work requirements. However, the majority of my patients with shoulder impingement pain are not athletes and do not perform overhead movements routinely.
Research has demonstrated the effectiveness of Physical Therapy interventions for the treatment of shoulder impingement pain. In addition, depending on the extent of the injury, shoulder impingement can be treated conservatively with the use of non-steroidal anti-inflammatories (NSAIDs) medicines, ice, and rest, which includes identifying and avoiding aggravating activities. While resting the inflamed tissues is beneficial, complete inactivity or nonuse of your shoulder is detrimental to tissue healing and may cause further shoulder problems.
Treatment: Our approach at Total Rehab for treating shoulder impingement focuses on a “hands on”, manual therapy interventions, which along with proper therapeutic exercises provides the best clinical outcomes. My training in orthopaedics and manual therapy allows me to provide an effective treatment approach by identifying the involved structures and tissues in your shoulder which is most likely causing your pain. Some examples of manual joint mobilization techniques that I use, and that are discussed in the literature, include a series of anterior, posterior, and inferior glides which have been demonstrated to provide significant pain relieving effects.1 Our goals for treating shoulder impingement are designed to address limitations in range-of-motion, strength, and flexibility to restore full overhead function and decrease pain.
If you want to learn more about how we can treat your shoulder pain, including shoulder impingement pain (or any other orthopaedic condition) schedule a FREE consultation in our South Ogden clinic to discuss how our individual, specialized care will benefit you!
Source: Kachingwe AF, Phillips B, Sletten E, Plunkett SW. Comparison of manual therapy techniques with therapeutic exercise in the treatment of shoulder impingement: a randomized controlled pilot clinical trial. Journal of Manual and Manipulative Therapy. 2008;16(4):238-247