Dealing With Shoulder Pain? It Could Be Shoulder Impingement Syndrome

(Swimmer’s Shoulder, Thrower’s Shoulder, Rotator Cuff Impingement, Subacromial Impingement, Supraspinatus Impingement)

What is Shoulder Impingement Syndrome?

Your rotator cuff is made up of four small muscles that stabilize your shoulder during functional movement. These muscles are attached to both the shoulder blade (scapula) and the upper end of the arm bone (humerus). One of these muscles, the supraspinatus, has a tendon situated in a very small space between the shoulder blade and upper arm. When shoulder impingement occurs, this supraspinatus tendon is getting pinched causing both tendon and bursa (a sac full of fluid that protects the tendons) irritation. Not only does this cause you pain, but it can severely limit your function.

This condition is also often associated with shoulder bursitis and rotator cuff tendonitis, though the conditions are slightly different. Shoulder bursitis occurs when the bursa becomes inflamed and swollen and rotator cuff tendonitis occurs when the rotator cuff tendons become irritated. Because of the close proximity of these tissues, shoulder bursitis and rotator cuff tendonitis often occur together in shoulder impingement.

Symptoms

You may have shoulder impingement if you’re experiencing one or more of the following:

Pain when raising your arm above your head or performing overhead motions like throwing
Difficulty reaching behind your back
Weakness in your shoulder muscles
A sense of your muscles grinding when you rotate or raise your arm
Pain when sleeping on the affected side

If your tendons have been injured for a long time, they can tear in two, causing a rotator cuff tear and may possibly require surgery. Therefore, if you are experiencing one or more of these symptoms, seek professional care from a licensed physical therapist immediately. If you neglect treatment, your condition will worsen and ultimately cause the need for a painful surgery.

Treatment

Below are some examples of what you can expect from treatment in physical therapy:

Heat/Ice treatment
Soft tissue mobilization
Joint mobilizations
Postural education
PROM stretches
Rotator cuff conditioning
Scapular stabilization exercises
Overhead reach mechanics re-education
Electrotherapy

The therapist will also provide you with a specialized home exercise program and teach you to perform the exercises correctly ensuring the quickest recovery.

Physical Therapy Exercises

The following are examples of exercises you may be prescribed in physical therapy. Please remember these do not apply to everyone and depend on your specific condition.

Shoulder Blade Squeeze: Start with your arms relaxed at your sides, then pull your shoulders back, squeezing and pinching your shoulder blades together. Make sure not to shrug your shoulders up. Hold for two seconds, release and repeat.
Shoulder Raises: Start by standing with your arms to your side. With thumbs directed up, and elbows straight, lift your arms to shoulder level at a 45 degree angle (between directly out to the side and direction in front of you). Do not let the shoulders shrug up toward your ears. Release and repeat.
Side-Lying External Rotation: Lying on your unaffected side, rest your affected arm on your topside torso with elbow bent to 90 degrees and palm resting on stomach. Squeeze the shoulder blade and rotate the arm up so that the palm faces the wall in front of you. Do not let your upper arm move off of your torso. Lower arm and repeat.
Shoulder Slide: Start with a slightly staggered foot stance about 1ft distance from the wall. Lean forward from your legs, so that you are not just hinging at your torso. Place your forearms on the wall so that they are parallel to each other. Without arching your back or shrugging your shoulders up to your ears, slide your forearms up as far as you can, while maintaining slight pressure into the wall. Keep your elbows in and wrists out so that forearms stay parallel. Lower to starting position and repeat.