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| Shoulder Impingement Syndrome: A Physical Therapy Guide |
Shoulder impingement syndrome is caused by the rotator cuff tendons being compressed repeatedly over time. The long head of the biceps tendon, the bursa, and the ligaments in the shoulder are examples of them. This impingement causes pain and difficulty moving. This syndrome can also be caused by a shoulder injury. Shoulder impingement is more common in people who do frequent overhead arm movements. It affects manual laborers and athletes more frequently (such as weightlifters, volleyball players, or baseball pitchers). Its development can also be aided by poor posture. A shoulder impingement, if left untreated, can develop into a more serious condition, such as a rotator cuff tear. Physical therapists assist persons with shoulder impingement syndrome in reducing discomfort and improving shoulder motion and strength.
Physical therapists are movement professionals that help people live better lives by:
- Hands-on attention.
- Patient education is important.
- Movement that is prescribed.
What Is Shoulder Impingement Syndrome, and How Does It Affect You?
When the tendons, ligaments, or bursa in the shoulder are repeatedly squeezed or "impeded," shoulder impingement syndrome develops. This results in pain and difficulty moving. The three bones that make up the shoulder are:
- The humerus is a bone in the human body (the long bone of the upper arm).
- Scapula is a type of capula (shoulder blade).
- Clavicle.
Impingement syndrome of the shoulder is also known as "subacromial" impingement syndrome. The bursa and the rotator cuff tendon are located beneath the acromion (a bony, bump-like prominence at the tip of the shoulder). These tissues under the acromion can get crushed or squeezed over time:
- Tendons of the rotator cuff. This ailment frequently affects these tendons the most.
- The biceps tendon has a long head.
- Ligaments.
- The bursa (a fluid-filled sac that acts as a cushion between the bony acromion and the rotator cuff tendon) is located between the acromion and the rotator cuff tendon.
- Compression and microtrauma to the tendon can also cause impingement symptoms.
What Does It Feel Like?
Shoulder impingement syndrome patients may have the following symptoms:
Shoulder motion is restricted, and actions such as reaching upward, behind the body, or out to the side are difficult.
When moving the arm upward, out to the side, and beside the body, it causes shoulder ache.
When attempting to sleep on the affected side, there is pain and discomfort.
Throwing actions and other dynamic overhead movements cause pain.
What Is the Process of Diagnosis?
Shoulder impingement syndrome can be diagnosed using an X-ray or an MRI. They also aid in the elimination of other conditions that may be causing your discomfort. Your doctor may order one of these tests before referring you to a physical therapist.
A full evaluation will be performed by your physical therapist. They will establish the severity of your ailment or injury, as well as any contributing variables. A single injury can result in shoulder impingement syndrome. It is considerably more likely, however, that it develops over time as a result of frequent discomfort in the shoulder area.
To begin, your physical therapist will gather information regarding your ailment. This will include information about your medical history. They may be aided by the forms you fill out before to your first appointment. Questions like these may be asked by your physical therapist:
- What happened to cause your injury?
- How have you dealt with the situation? Have you seen other doctors or had any imaging or other tests done, and what were the results?
- What are the signs and symptoms you're experiencing right now? Do they change over the day?
- What is the location and intensity of your pain, if there is any? Is your pain different throughout the day?
- Are there any activities that you haven't been able to do or that you've had trouble doing since your injury?
They'll keep track of any activities that aggravate or alleviate your symptoms.
This information aids your physical therapist in gaining a better understanding of your condition and determining the scope of your physical examination. The physical exam will differ depending on the circumstances, but it will usually begin with watching the movements that were discussed throughout the interview. It will include the location where you are experiencing symptoms as well as any nearby regions that may have changed since your symptoms began. Your physical therapist may assess your lower arm, neck, and posture, for example.
Your physical therapist will do the following during your examination:
- Keep an eye on how you lift your arm and shoulder overhead, as well as how you perform other reaching exercises.
- Examine your shoulder and other body parts for mobility and strength.
- Palpate (feel) your shoulder and surrounding area gently but expertly to pinpoint the source of pain.
The physical exam will assist establish which areas of your condition need to be treated in order to improve.
Your physical therapist will talk to you about their results. They will collaborate with you to create a plan that will kick-start your rehabilitation.
What Can a Physical Therapist Do for You?
When shoulder impingement syndrome develops, it's critical to get therapy as soon as possible. If left untreated, it can lead to secondary conditions such as:
- The bursa is irritated.
- Tendonitis or rips in the rotator cuff.
Shoulder impingement syndrome can be successfully treated with physical therapy. Your physical therapist will collaborate with you to create a treatment plan that is tailored to your individual needs and objectives. The following items may be included in your individualized treatment plan:
- Patient education is important. Your physical therapist will explain your problem to you. They'll work with you to figure out what's causing your discomfort. They may advise you to adjust the type and amount of workouts you do, as well as your sporting activities and activities at home or at work. They'll create a custom fitness regimen for you to ensure a pain-free return to your favorite hobbies.
- Management of pain. Your physical therapist will devise a treatment plan for you that involves icing the affected area. They may also suggest that you change some of the activities that are causing you pain. Physical therapists are skilled at prescribing pain-management approaches that lessen or eliminate the need for pharmaceuticals, such as opioids.
- Management of pain. Your physical therapist will devise a treatment plan for you that involves icing the affected area. They may also suggest that you change some of the activities that are causing you pain. Physical therapists are skilled at prescribing pain-management approaches that lessen or eliminate the need for pharmaceuticals, such as opioids.
- Manual therapy is a type of treatment that involves the use of Your physical therapist may use "hands-on" treatments (manual therapy) to gently move your muscles and joints to treat your ailment. These strategies aid in the improvement of motion. They can also be employed to help the region migrate in a less traumatic manner.
- Muscle development. Because the scapula deviates owing to weakness, muscle deficiencies or imbalances can contribute to impingement of the shoulder joint. Your physical therapist will create a safe, individualized, progressive resistance program for you based on the severity of your injury. It could consist of your core (midsection). Begin by doing strengthening exercises while lying on a treatment table or on your bed or floor at home. After that, you can go on to standing exercises. Based on your age and physical condition, your physical therapist will determine which exercises are appropriate for you. At the clinic, you might use resistance machines as part of your plan. Your physical therapist will also assess whether or not it is safe for you to go to the gym.
- Training that is functional. You'll need to gradually return to more demanding tasks after your discomfort, strength, and range of motion have improved. It is critical to teach your body safe, controlled movements in order to reduce stress on the shoulder joint. Your physical therapist will design a series of activities based on your movement evaluation and goals to help you learn how to use and move your body correctly and securely. Retraining of actions such as throwing, swinging a racket, or a work activity are examples.
Is it possible to prevent this injury or condition?
Shoulder impingement syndrome can be avoided by doing the following:
- Maintaining adequate shoulder and shoulder-blade muscular strength. The right balance of muscular strength in the shoulder region is essential for a healthy shoulder. If your muscle strength is imbalanced, you're more likely to get impingement and injury over time.
- Maintaining adequate range of motion and mobility in the shoulders, neck, and middle back. To sustain healthy, appropriate function, the shoulder relies on the mobility of adjacent joints.
- When reaching and throwing, maintain appropriate posture and use proper shoulder mechanics. This decreases the risk of shoulder impingement and relieves excessive shoulder tension.
- Avoiding poses with a forward head and rounded shoulders (such as spending a lot of time hunched over, sitting at a computer). Poor posture causes the shoulder to be placed in postures that increase the risk of impingement.
Which Physical Therapist Do I Require?
Through education and experience, all physical therapists are trained to treat shoulder impingement syndrome. When looking for a physical therapist, keep the following in mind:
- A physical therapist who has treated patients with shoulder impingement syndrome before. Some physical therapists specialize on orthopaedic and musculoskeletal conditions.
- A physical therapist who has completed a residency or fellowship in orthopaedic or sports physical therapy, or who is a board-certified clinical specialist. This physical therapist possesses advanced knowledge, experience, and skills that may be useful in treating your problem.
Identify a PT, an online service created by the American Physical Therapy Association to assist you search for physical therapists with specific clinical specialty in your geographic area, to find physical therapists with these and other certifications.
- Seek advice from family, friends, or other health-care professionals.
- When making an appointment with a physical therapy clinic, inquire about the physical therapists' experience in treating clients with shoulder impingement syndrome.
- Prepare to discuss your symptoms in as much detail as possible during your initial session with the physical therapist, as well as what makes them worse.
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