Updated: Aug 31, 2020
Shoulder impingement is a very common diagnosis that I see in my Physical Therapy practice. While it is a fairly easy condition to diagnose because of its common symptoms and presentation, that does not mean we shoulder treat every case of shoulder impingement with the same exercises or treatment techniques. The shoulder is a very complex joint and there are a lot of parts that must work together for proper shoulder health and function. To help you better understand the complexity of working with the shoulder, I will outline what shoulder impingement actually is and the common signs, why it can happen, and what you should do if you have been diagnosed with shoulder impingement or are experiencing similar symptoms.
What is Shoulder Impingement?
Shoulder impingement is caused by irritation to the rotator cuff tendons, biceps tendon, or bursa in the subacromial space (see picture - space below the acromion). Common symptoms include:
Pain in the front of the shoulder with overhead movements
Limitations in shoulder range of motion (ROM) due to pain, specifically reaching up and behind the back
Painful arc of motion between 60 and 120 degrees of shoulder flexion
What Causes Shoulder Impingement?
As I mentioned previously, the shoulder is a very complex joint. The shoulder is a very mobile joint, which is important because it allows us to perform a variety of movements with our arms. However, it is inherently unstable due to its structure, which allows for it to be so mobile. What this means, is that there is very little boney stability in the shoulder and the shoulder relies very heavily on the surrounding muscles to provide stability. The best illustration for this is to picture a golf ball sitting on a tee, the golf ball is much larger than the tee. The ball is much larger than the socket, so for proper function of the joint it is very important that the ball stay in the center of the tee.
It is the role of the rotator cuff muscles to keep the ball in the center of the socket. If these muscles are weak or not working in coordination, it can allow the ball to track off center in the socket and this can impinge on the structures in the subacromial space (as pictured above). Over time, this can lead to irritation and inflammation causing pain in the shoulder.
The shoulder joint also does not function in isolation, but rather the whole shoulder complex must function together. As you can see in the image, there are multiple muscles and joints that make up the shoulder complex. Any restriction, weakness, or deficit within this complex can lead to the shoulder not functioning properly, which can lead to compensation patterns and again can eventually lead to pain and dysfunction. It is important to evaluate all of these areas to determine the root cause of shoulder impingement.
What Should You Do if You Have Shoulder Pain or Have Been Diagnosed With Shoulder Impingement?
If you are experiencing shoulder impingement or shoulder pain, here are a few simple things you can do to help with your symptoms:
Keep working out and being active. It is important to try and maintain a normal activity level. However, it is recommended to modify or avoid movements that cause pain greater than 5/10 on the pain scale.
Pay attention to your postural habits. Some of us sit for extended periods of time at work and most of us are guilty of too much time on our phones. These prolonged positions can lead to tightness and decreased mobility, which can impact the function of the shoulder joint.
Keep your shoulder moving. It is sometimes our tendency to stop moving our arm into painful positions; however, pain does not always indicated we are doing more harm. "Motion is lotion." As this saying goes, it is important to keep the joint moving to increase blood flow and joint fluids.
Learn more. To learn more about shoulder pain and additional tips visit my webpage dedicated to shoulder pain: www.enhanceptdsm.com/shoulder-pain. Here you will also find my FREE report: 7 Ways to Ease Shoulder Pain So You Can Keep Up With Your Workouts.
Work with a Physical Therapist. Last but certainly not least, working with a qualified Physical Therapist is the fastest way to improve your shoulder pain. As is discussed throughout this blog, the shoulder joint is very complex and it is critical to know the specific cause of your shoulder pain or impingement in order to develop a customized treatment plan to get you the long-lasting results you are looking for in order to keep you participating in your favorite activities.
If you want to get to the bottom of your shoulder impingement or shoulder pain, so you can get back to living your life to the fullest, CALL or TEXT 515-985-9038 to schedule a FREE Discovery Session Today!!! In this FREE Discovery Session, we will figure out the root cause of your problem and educate you on the recommended recovery plan. You can also have any of your specific questions answered. We look forward to working with you!