What is shoulder impingement?
Shoulder impingement is a condition in which the tendons or bursa within your shoulder joint get trapped intermittently during shoulder movement. Trapping of these structures can cause sudden onset of pain and loss of movement, continually trapping or loading of these structures can result in tendonopathy or bursitis with ongoing pain.
Why does it happen?
Shoulder impingement occurs due to reduced space within the shoulder joint. This reduced space can be caused by several factors including; inflammation, altered biomechanics, an in-balance in muscle strength, reduced muscle length or injury to the shoulder or surrounding tissue. Altered biomechanics can involve physiological changes to the shoulder joint itself or faulty movement patterns of the shoulder or shoulder blade. Shoulder impingement is often aggravated with overhead activity or heavy manual labor work.
What can a physiotherapist do?
Your physiotherapist will complete a postural assessment in conjunction with diagnostic tests to help determine the cause of your shoulder pain.
Treatment for impingement based shoulder pain will vary for each individual and depends on the contributing factors. Treatment could involve soft tissue work or stretches to reduce the tightness of muscles that are having implications on the position of your shoulder joint. An exercise program will be developed to assist in the providing optimal biomechanical functioning of the shoulder. Faulty movement patterns of the shoulder complex can be habitual and take patience and perserverance to correct. The physiotherapist will be able to assist you with this and may use hands on facilitation or bio-feedback to help stimulate optimal muscle activation.
Return to sport/work
Return to work and sport varies to each individual and is often pain limited. The physiotherapist can offer adjunct treatment to help manage the pain during work and sport including ergonomic advice, postural corrections, supportive taping and self management techniques.
Eight to twelve weeks of a thorough rehabilitation process is often recommended to have long term effects on your impingement based pain. If no improvement is seen over this time referral to an orthopaedic surgeon may be recommended.