Most of us have probably experienced some type of shoulder issue over the years and
shoulder impingement is one of the most common shoulder issues that can cause you pain. If you have shoulder pain, stiffness, or weakness identifying whether you have shoulder impingement can be the first step in getting you back to what you love to do.
The shoulder is complicated and can be a tricky area for you to try to figure out what is going on. If you feel on top of your shoulder where your upper trapezius muscle runs from your neck to the side of your shoulder you should feel a hard bump that rises more prominently towards the sky. This is a bone and part of your AC joint (acromioclavicular joint) that combines your acromion, which is part of your shoulder blade with your clavicle, or collar bone . The acromion rises above one of your rotator cuff muscles with a small amount of space between the muscle and the bone which acts like a ceiling. If the shoulder isn't moving as well as it could be the muscles gets pinched into the acromion.
Note: This is describing the most common type of shoulder impingement. The other types are similar in that thay all are related to soft tissues getting pinched in between bones which causes pain, stiffness, or inflammation.
With the impingement the tendons of the shoulder tend to get inflamed and usually cause pain in certain positions, especially when reaching overhead. This can occur because of a combination of abnormal movement and overuse of the shoulder with repetitive overhead movements. Although surgery and injections are utilized as a form of treatment, in the overwhelming majority of cases shoulder impingement can be treated successfully with less invasive techniques.
-Unable to move your arm through the full range of motion
-You have to move your arm abnormally overhead or in other motions
-Difficulty reaching behind the back
-Pain/clicking in the front or top of the shoulder when raising out to the side or overhead
-Difficulty sleeping at night due to pain (lying on involved shoulder)
-Weakness in the shoulder/arm
-Diagnosis is made be a hands on assessments by a physical therapist, sports medicine doctor, or Orthopedist.
(An Orthopedist or a sports medicine doctor will then refer you to a physical therapist for treatment.)
-Diagnosis can be made by MRI, but to be honest this is not needed. Shoulder impingement is an easy diagnosis to make when combining how you move, what causes your pain, and special tests we perform with our hands. We often hear from people calling us to ask if they should get a MRI before they come in. MRI's are meant to find damage, but not the cause of the damage. A hands on assessment from a Physical Therapist, Sports Medicine Dr., or Orthopedist finds what is damaged and what caused the damage. The MRI will not guide your rehab, but rather what we find with our hands on assessment does. If we think that surgery may be called for (it almost never is with shoulder impingement) we will order a MRI for you and communicate with a potential surgeon.
Treatment and What You Can Do To Get Relief
As stated above surgery and injections are one form of treatment but they should be used as a last resort to alleviate the pain. Physical Therapy is the preferred method for shoulder impingement and would include
hands on manual techniques, dry needling (if needed and wanted), soft tissue work, joint mobility work, stretching, strengthening, kinesiotaping (if needed), and whatever else you needed that would get you better.
Most people assume that they can just complete exercises to heal their shoulder, but it is important for a professional to give a full hands on assessment because sometimes exercises actually can make the problem worse. Shoulder impingement is typically due to a muscle imbalance that is affecting how you are moving and a overuse/stress injury to the rotator cuff muscles. Rest is also not an answer. While it may cause the pain to go away when you start back with your activities the underlying problem will still be there and the pain will return. A physical therapist will determine which specific muscles are weak, which joints are not moving the way they should, how you need to gain more control with the shoulder and how that is playing into the underlying condition. It is important to address what the cause of the impingement is and attack it to prevent a future reoccurrence. With proper treatment you should start noticing pain reduction and movement improvement fairly quickly (1-2 weeks or less).
If you want even more information to figure out what you should do about your shoulder please consider downloading our FREE ebook on shoulder pain by clicking the the image of the 13 Ways To Tell If Your Shoulder Pain is Normal...And If you Should See Someone About It.
If you want to get active again, move better, or even just be able to get through the day without pain then please consider scheduling a free 20 min phone call to see if we can help. Click the button
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