How Can Physical Therapy Help with Shoulder Impingement?
What is impingement of the shoulder?
A common source of shoulder pain is a condition known as shoulder impingement syndrome. It transpires as a result of the overuse of or injury to the rotator cuff tendons, ligaments, or bursa in the shoulder. As one becomes compressed or pinched, the result is prolonged pain accompanied by a reduction of everyday motions and movement in the shoulder.
Causes of shoulder impingement syndrome
Overuse or injury occurs when impingement and microtrauma damage the tendons as a result of the following:
- an injury which results in shoulder compression such as a fall
- repeated raised movements such as continual overhead lifting, reaching, or repetitive movements like painting, swimming, or throwing
- inadequate strength in the rotator cuff or shoulder blade
- constriction or limitations in movement of the soft tissue around the joint capsule
- bony irregularities of the acromion that result in a shrinking of subacromial space
- a thickening of the bursa or ligaments in the shoulder region
- the presence of osteoarthritis in the shoulder area
Symptoms and signs
Most patients report an onset of shoulder pain that steadily increases over time. When performing overhead movements, pain usually presents itself at the front and on the side of the shoulder joint. Pain may also be evident when the arm is positioned out to the side and rotated outward or when lifting the arm laterally and up above the shoulder. Most patients report a weakness in the shoulder muscle as well as a struggle to reach up and behind the back.
Prolonged tendon injuries can lead to a rotator cuff tear or a rupture in the bicep muscle causing intense pain and a limited ability to elevate the arm.
How is the condition diagnosed?
Diagnosis includes a discussion regarding your medical history and symptoms followed by a physical examination of your shoulder. Your doctor will be looking for tenderness or abnormalities as well as assessing range of motion and muscle strength.
Imaging tests such as x-rays, MRI, or ultrasound may be ordered depending on the findings of the physical examination.
How a physical therapist can help
Physical therapy is a pivotal part of managing and treating shoulder impingement syndrome. As every patient’s condition is unique, your physical therapist will create a treatment plan that is structured to meet your individual needs.
A physical therapist can assist in your recovery in the following ways:
Education
A physical therapist can assess your posture and your habits in order to devise modifications to your work and home environments and encourage activities that will promote positive changes in your mobility and pain levels.
Exercises
Your physical therapist will teach you how to perform exercises that encourage strength, flexibility, and range of motion in an effort to return to normal movement without experiencing pain.
Pain management
Part of your therapy will involve recognizing and avoiding the movements that cause pain. Working on correct posture formation and maintenance will help to minimize impingement compression. Your physical therapist may utilize ice, patches, and ultrasound techniques that are known to be beneficial in both pain reduction and management.
