By in Joints & Muscles, Sports Injury

Shoulder Impingement

A shoulder impingement (often referred to as a subacromial impingement) causes pain and restricted range of movement of the affected joint due to sensitivity and/or injury to soft tissues above the ball and socket of the shoulder joint.

The shoulder girdle is made up of the ball and socket, called the Glenohumeral joint and the scapulothoracic joint where the shoulder blade articulates with the rib cage. Muscles from the shoulder blade that cross the glenohumeral joint, as a group, are called the rotator cuff. It is the tendons of the rotator cuff that become sensitive in an impingement.

There are multiple ways this can happen, from swelling in the tendons due to trauma or repetitive mechanical irritation to a bone spur that presses on the tendons when the arm is in certain positions. The pain can be debilitating and persist for a long time unless addressed with appropriate rehabilitation, however, it is difficult to know when to get help as the pain usually begins at a low intensity only to get worse as time passes if behavioural changes aren’t addressed.

It is also important to have a full assessment of the shoulder to rule out other possible causes of the pain such as arthritis or adhesive capsulitis (otherwise known as a frozen shoulder).

Despite there being a clinical pattern to the pain presentation, patients will often get referred for a scan. This is usually an ultrasound to identify which tissues are affected. However, this is often unnecessary unless conservative management hasn’t worked for over six weeks or more.

In my experience, the sooner someone presents and begins rehab exercises, the quicker their pain reduces and resolves. When I have seen patients that have been suffering for long periods, it can take up to three months to be pain-free but that is still better than relenting to surgery or injection that doesn’t seem to have any better long term outcome than conservative rehab.

Studies have suggested that conservative rehab and strengthening can reduce the need for surgery in 75% of cases in shoulder impingement, and I feel that is far more advantageous given the length of recovery post-surgery can be many months.

If you are concerned about the possibility of an impingement in your shoulder do not hesitate to get in contact with The Body Matters where we can direct you to the most appropriate therapist for you.

Louise