Shoulder Impingement (jenna/michael)

Shoulder impingement occurs when the rotator cuff does not perform as intended, and structures become compressed.

The rotator cuff refers to the supraspinatus, infraspinatus, subscapularis, and teres minor muscles. A function of the rotator cuff is to keep the head of the humerus, a bone of the arm, tucked in its socket tightly when the arm is moving. When the rotator cuff fails to do so, tendons and bursae may be compressed resulting in irritation and inflammation if left untreated. Identifying early onset of shoulder impingement is crucial to the rehabilitation of the condition. Otherwise, prolonged inflammation can cause decreased muscular efficiency, creating a downward trend, and the biceps tendon or supraspinatus tendon could rupture. Some potential factors that could lead to shoulder impingement involve repetitive overhead movement with the arms, weakness or instability in the shoulder, and/or reduced subacromial space due to bone deformation. ​

symptoms

  • Arm pain
    • Often low in severity but constant
    • May be in front of the shoulder and/or over the biceps
    • Worse at night
  • Shoulder or arm weakness

causes

  • Overuse
    • High-risk occupations include construction work, movers, and painters
    • High-risk sports include swimming, tennis, and baseball
  • Age
  • Previous injury
  • Abnormal acromion shape

treatment

  • Rest
  • Ice therapy
  • Pain medication (NSAIDs)
  • Physiotherapy
  • Surgery, in extreme cases

How does physiotherapy help?

  • Ice therapy (10-15 minutes at a time, a few times a day)  can help relieve swelling and pain in the shoulder
  • Intramuscular stimulation (IMS) induces local inflammation to improve blood flow, aid in healing, and reduce pain 
    • Promotes relaxation of the injured and surrounding muscles, reducing any spinal nerve or joint compression, and thus allows for improved mobility
  • Exercise prescription and modification can target the muscles of the shoulder, which will help improve stability, strength, and range of motion. 
    • Increasing the strength of the rotator cuff muscles will be beneficial to prevent reinjury or impingement recurrence