What is Shoulder Impingement Syndrome?
Impingement syndrome is when the soft tissues in and around the shoulder joint are repeatedly jammed up by the bones around them. This issue usually occurs when the arm is about halfway to the overhead position. Impingement syndrome, therefore, can limit your ability to lift the arm at all or to use it with any force in that position, such as throwing a ball or writing on a whiteboard. This conditions usually involves inflammation of the rotator cuff tendons and most commonly occurs in people over 40 years old although it can occur in people under 40 years old in which the subacromial bursa is inflamed.
What causes impingement syndrome?
Shoulder impingement syndrome can be caused by many reasons which include:
- Poor posture can have an impact on your shoulder blade muscles, therefore, increasing the risk of impingement.
- Sudden change or increase of overhead activity can also increase your risk of impingement condition.
- When the space between the arch of the shoulder blade (acromion) and the shoulder bone (humerus) becomes narrower than it already is. Resulting in irritation and damage to the cuff tendons, therefore, causing pain.
- When space is narrowed it can cause changes in the bony structures, such as spurs from the AC (acromioclavicular) joint or soft tissue changes.
How do I know if I have impingement syndrome?
You may have shoulder impingement syndrome if you experience the following:
- You experience pain when you lift your arm (especially out to the side). The pain will be the worse when between 60o and 120o
- You may experience worse pain at night
- If you have injured your shoulder the pain will come on quickly whereas if there is no injury, then the pain will come on gradually with a repeated or sustained hand overhead activities.
- You may hear or feel a popping or grinding sensation when you move your shoulder.
Your physiotherapist will need to examine you through completing a few tests to confirm a diagnosis. It’s vital to remember that no single test can give all of the answers, this is why a variety of tests will be completed to find the best treatment for you.
How can physiotherapy help with impingement syndrome?
Physiotherapy can help you with the following if you have impingement syndrome:
- Changing posture or position – It is possible to change your shoulder posture by taping to allow for more room for the inflamed tendon and/or bursa. You will be advised by your physiotherapist ways that you may move your shoulder so that it does not hurt. This may even allow the muscles to work better and improve inflammation.
- Pain management – Physiotherapy concentrates on reducing pain and inflammation whilst preventing further impingement and tissue damage. Your physiotherapist may recommend medication to daily activities, resting and icing shoulder as well as performing massages. In the early stages of management, ice or heat may be helpful. Your physiotherapist may also use a low-level laser to reduce your pain and inflammation around the tendon
- Strengthening – You will be advised by your physiotherapist of exercises to complete to although you to strengthen your shoulder. These exercises will be suggested once your symptoms improve. All exercises should be pain-free and if they aren’t then you must report this to your physiotherapist.
What can I do at home?
It is vital that you ensure to listen to the advice your physiotherapist has given you. It is advised that you concentrate on your posture when you sit and stand. When you stand it is important to ensure some part of your legs touches instead of slouching.
You may be given exercises at home to complete by your physiotherapist ensure you complete them to allow for maximum recovery. These exercises will be based on your condition and capability.
How long will my recovery be?
It is important that you do not continually inflame the structures of your shoulder. If you ensure your shoulder is in the correct position repetitively then your condition should settle in 6-12 weeks. If you participate in sports that this may take a longer time to recover fully, ask you, physiotherapist, for more information.
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Reference: Australian Physiotherapy Association 2019, Your Body, viewed 19 November 2019, < https://australian.physio/>.