Shoulder impingement is a condition that arises when there is sensitivity or pinching of the soft tissue structures in the shoulder, often due to an injury. This pinching can occur during certain movements, such as lifting your arm to the side or in front of your body at shoulder level, and is exacerbated by rotating or twisting the arm downwards. The structures involved include the rotator cuff, bursa, biceps tendon, and ligaments of the shoulder.
Inflammation and swelling from an injury are common contributors to the signs of impingement. This condition could also indicate more severe issues like a rotator cuff tear or the presence of a bone spur. Factors such as poor posture or weak shoulder blade muscles can lead to impingement, highlighting the importance of maintaining proper alignment and muscle strength.
Diagnosis
Diagnosing shoulder impingement typically involves a trained medical professional, such as a physical therapist or orthopedist, who can perform special tests in their office. X-rays may also be utilized to rule out other causes of shoulder pain.
Managing shoulder impingement involves several strategies:
- Avoid movements that exacerbate the pain, such as lifting or reaching awkwardly.
- Ensure proper shoulder blade positioning during arm movements.
- Avoid sleeping on the affected arm or propping it in uncomfortable positions, like on a car door while driving.
- Physical therapy can help mobilize the shoulder and correct posture and alignment issues.
- Strengthening exercises for the rotator cuff, such as external rotation while lying on your side, are beneficial.
- Stretching may be uncomfortable initially but can aid in recovery. Examples include pulling the arm across the chest or the sleeper stretch.
Additionally, cold therapy can help reduce pain, and nonsteroidal anti-inflammatory drugs (NSAIDs), like Ibuprofen or Naproxen, may be used if medically appropriate. Consultation with a doctor is advised before starting any medication. In some cases, treatments like cortisone injections or even surgery may be necessary, though most orthopedists prefer to refer patients to physical therapy first.
If left untreated, shoulder impingement can persist and lead to more severe conditions requiring invasive treatments. Hence, addressing the symptoms early and engaging in appropriate therapeutic exercises and modifications to daily activities is crucial.
My PT treats shoulder impingement frequently, performing special tests that help us learn your source of pain. Joint mobility, posture imbalance, muscle weakness, tendon tears, and trigger points are all common problems we can work on in physical therapy.