What is Shoulder Impingement and How Can Physiotherapy Help?

Shoulder impingement is a common condition that can cause pain and reduced range of motion in the shoulder. It occurs when tendons or bursae (small fluid-filled sacs) in the shoulder become compressed or pinched as the arm is raised. This can lead to inflammation, pain, and decreased mobility in the shoulder. Shoulder impingement is a common condition that affects athletes, individuals with physical jobs, and people who perform repetitive overhead movements. It can also occur as a result of natural aging and degenerative changes in the shoulder.

Common causes of Shoulder Impingement

Shoulder impingement can be caused by several factors, including:

• Repetitive over head activity i.e painting a ceiling or lifting objects

• Weakness or injury to the rotator cuff (deep shoulder muscles)

• Fall on an out stretches arm

• Spurs developing around the area adding to likelihood of impingement 

• Poor sitting posture with your shoulders sitting forward

Symptoms of Shoulder Impingement

Symptoms can vary a lot, depending on the degree of damage and swelling to the injured tissue, but commonly present as:

• Pain in the shoulder, especially when raising the arm above shoulder height

• Weakness in the shoulder

• Stiffness or reduced range of motion in the shoulder

• A clicking or popping sound when moving the shoulder

• Inflammation or swelling in the shoulder

Physiotherapy for Shoulder Impingement

Physiotherapy is a highly effective treatment for shoulder impingement. A physiotherapist can develop an individual treatment plan that addresses the underlying cause of the condition and helps to reduce pain and improve mobility. Some common physiotherapy treatments for shoulder impingement include:

Image 1: Site of shoulder impingement

Stretching and Strengthening Exercises

Stretching can be used in conjunction with a strengthening program to support improved posture. By improving posture, we increase the subacromial space where the impingement occurs (see image 1 and 2). Strengthening is also a key aspect of improving the strength and function of your rotator cuff muscles. These a deep shoulder muscles that stabilise the humeral head (shoulder bone if you like) and limit/prevent impingement.

Manual Therapy

Hands on manual therapy is important to reduce the acute pain and muscle tightness around the shoulder and neck related to the shoulder impingement. It can further help to stretch out parts of the tissue that are tight to endorse better movement and reduced pain.

Imaging

If needed your Physio can refer you directly for an x-ray or an MRI to further investigate the condition and know exactly what the best course of action would be to get you back to your best quickly.

Taping

As mentioned above posture can play a large part. Your physio can use tape to help to pull back your shoulder and decompress the impingement, as well as tape the shoulder in a way that limits unwanted movement and unloads the injured tissue.

Cryotherapy

At Aevum we often use a Game Ready Med4 Elite unit, this is a fully encompassing shoulder wrap that has chilled water running through it to provide rapid cooling to reduce the inflammatory process. Concurrently, the wrap also inflates with air to provide some compression over the area to assist swelling resolution. This is often done at the conclusion of your physiotherapy appointment to provide added benefit.

Education and Home Exercise Program

Education and a home exercise program are an essential part of physiotherapy for shoulder impingement. Your physiotherapist can educate you about the condition, provide guidance on proper posture and body mechanics, and develop an individualised home exercise program to continue improvement and prevent future recurrences.

Shoulder impingement is one of the most common presentations in the Sutherland Shire and can be a cause of considerable pain and limitation to work and day-to-day tasks. The good news is that it can be fixed.

FAQ:

Q1. What are the causes of shoulder impingement?

A1. The causes of shoulder impingement can include overuse or repetitive overhead movements, poor posture, weak shoulder muscles, injuries to the rotator cuff or other shoulder structures, natural aging and degenerative changes, and bony growths or spurs on the bones of the shoulder.

Q2. What are the symptoms of shoulder impingement?

A2. The symptoms of shoulder impingement can include pain in the shoulder, especially when raising the arm, weakness in the shoulder, stiffness or reduced range of motion in the shoulder, a clicking or popping sound when moving the shoulder, and inflammation or swelling in the shoulder.

Q3. What is physiotherapy and how is it helpful for shoulder impingement?

A3. Physiotherapy is a highly effective treatment for shoulder impingement that can help to reduce pain, improve mobility, and prevent future recurrences. It involves a customised treatment plan that can include stretching and strengthening exercises, manual therapy, taping and bracing, and education and a home exercise program.

Q4. What are the common physiotherapy treatments for shoulder impingement?

A4. The common physiotherapy treatments for shoulder impingement include stretching and strengthening exercises, manual therapy, taping and bracing, and education and a home exercise program.

Q5. What should I do if I am experiencing symptoms of shoulder impingement?

A5. If you are experiencing symptoms of shoulder impingement, you should contact a physiotherapist to start your journey to a pain-free shoulder. The physiotherapist can develop a customised treatment plan that addresses the underlying cause of the condition and helps to reduce pain and improve mobility.