The Truth about Shoulder Impingement

The Truth about Shoulder Impingement

 

Shoulder Impingement accounts for 65% of shoulder pain and functional limitations and is often not treated early enough.  To fully understand shoulder impingement its necessary to understand the anatomy of the shoulder.

The shoulder is a ball and socket joint built for mobility.  The shoulder joint is composed of 3 bones: the humerus, the scapula and the clavicle.  Shoulder Impingement is the pinching or compression of rotator cuff muscle tendons, ligaments or bursa under the acromion.  The acromion is the top hook of the scapula that meets the clavicle at the outer point on top of the shoulder.  The rotator cuff is composed of 4 muscles: the supraspinatus, the infraspinatus, teres minor and subscapularis.  The supraspinatus tendon passes under the acromion and the bursa provides cushion and lubrication to the tendon.  The tendon becomes painful due to microtrauma from compression.

Shoulder Impingement causes pain, decreased motion, weakness causing difficulty lifting your arm overhead or out to the side as well as painful sleep in positions with pressure on the affected shoulder.  Shoulder impingement with chronic trauma to the rotator cuff tendon can result in more serious injuries including a rotator cuff tear.  As a result, it is important to seek treatment early, which decreases risk for serious injury, improves quality of life and is less costly.

Physical Therapy should be the first step in treating shoulder impingement.  It can be diagnosed through a compressive clinical assessment without the need for expensive imaging and can be treated conservatively with success rates >90%.  In fact, research shows that those undergoing surgery for shoulder impingement have a recurrence rate over 50% and the total cost of treatment is 10x higher than physical therapy.  Discussion around why the recurrence rate is high supports the need to evaluate and treat external factors such as posture, stretching of the chest and anterior shoulder, strengthening of scapular stabilizing muscles and ergonomics which can’t be managed with surgery alone.

Remember- You can have shoulder impingement without an injury.  So, if you are suffering with shoulder pain please give Access Group Physical Therapy at 651-330-2286 for a free consultation.

 

 

Sources:

Mulcahy, J.  Physical Therapist’s Guide to Shoulder Impingement. 8/24/18. https://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=1793961e-c552-4367-b3fb-61a1467b793

Khan Y, Nagy MT, Malal J, Waseem M. The painful shoulder: shoulder impingement syndrome. Open Orthop J. 2013;7:347–351.

Faber E, Kuiper JI, Burdorf A, Miedema HS, Verhaar JA. Treatment of impingement syndrome: a systematic review of the effects on functional limitations and return to work. J Occup Rehabil. 2006;16(1):7–25.