Shoulder Impingement Syndrome: Typical Causes, Symptoms & Treatment Advice
Shoulder impingement syndrome is a condition where the rotator cuff muscles and tendons become compressed or irritated during particular shoulder motions. This contributes to damage and injury to shoulder structures such as the tendons, ligaments, bursa and joint capsule. When this occurs these structures become inflammed and therefore cause pain and overall dysfunction. While a traumatic injury can certainly cause shoulder impingement syndrome to develop it is most commonly the result of a repetitive overhead type activity or exercise.
CAUSES OF SHOULDER IMPINGEMENT SYNDROME
Anatomically the rotator cuff structures of the shoulder are protected by ligaments. The rotator cuff tendons surrounded various bony landmarks including the subacromial fossa. This fossa is a common sight where the supraspinatus muscle may become impinged. Shoulder impingement syndrome is categorized into either:
- Primary (Structural) causes
- Secondary causes
- May be the result of shoulder joint instability as seen with cases of shoulder dislocation, repetitive overhead actions (i.e removing clothes from a clothesline, particular gym exercises or particular occupations)
CLASSIC SIGNS & SYMPTOMS
Typical signs & symptoms that you’re suffering from shoulder impingement syndrome include (but not limited too):
- Shoulder pain upon particular movement or ranges of motion
- Difficulty lying on the effected shoulder
- Pain or discomfort that may be localized to the shoulder, proximal neck and arm
- Muscle weakness during specific arm exercises
HOW IS SHOULDER IMPINGEMENT SYNDROME DIAGNOSED?
As with all clinical presentations it is essential to rule out other potential diagnoses which may influence clinical treatment and therefore patient outcomes. This means that a thorough clinical assessment is critically important. When you visit Vitality Chiropractic Australia your treating practitioner will perform a comprehensive shoulder regional examination after discussing your complaint with you. This discussion is necessary as it will guide your examination. During a shoulder regional examination you can expect:
- Palpation assessment to observe for specific tenderness, pain, swelling or skin changes
- Analysis of your shoulder joint range of motion
- Muscle strength testing to see if there is particular weakness or asymmetry
- Orthopaedic and neurological assessment
SHOULDER IMPINGEMENT SYNDROME TREATMENT
Researchers have concluded that there are essentially 7 stages that need to be covered to effectively rehabilitate injuries like shoulder impingement syndrome which include:
- Protection, immediate pain relief and anti-inflammatory measures after injury onset
- Assist with regaining complete shoulder joint movement and range of motion
- Restore proper scapular control and scapulohumeral rhythm
- Exam and treat cervicothoracic biomechanics if necessary
- Progress rehabilitation towards rotator cuff strengthening based exercise
- Initiate speed, power, propriception and agility rehabilitation
- Return to usual activities of daily living
Your local Chiropractor or Physiotherapist are brilliant choices to assist you throughout your rehabilitation. While conservative management is recommended, other potential short term treatment options may include Corticosteroid injections. These injections are useful to relieving pain that is due to inflammation. It is important to recognize that this treatment will not correct your shoulder impingement syndrome however may provide fantastic pain relief in the early stages of rehabilitation.
WHAT DOES THE RESEARCH TELL US?
- Individuals suffering from shoulder impingement syndrome who were treated with manual physical therapy (such as Chiropractic and Physiotherapy) combined with a specifically tailored exercise regime demonstrated clinically significant improvement in symptoms including increasing strength, decreasing pain and improving function earlier than with exercise alone. Senbursa, G. (2007). Comparison of conservative treatment with and without manual physical therapy for patients with shoulder impingement syndrome: a prospective, randomized clinical trial. Knee Surgery, Sports Traumatology, Arthroscopy, 15(7); 915 – 921
- Kinesiotape has been found to be more effective than other modalities during the initial stages of treatment. Kaya, E. (2010). Kinesiotaping compared to physical therapy modalities for the treatment of shoulder impingement syndrome. Clinical Rheumatology, 30(2); 201 – 207.