Shoulder Impingement Syndrome
Shoulder impingement syndrome is a common condition leading to pain in the shoulder region. Rather than a specific diagnosis, it is collection of signs and symptoms and can involve one or more of several shoulder structures. Due to a fairly narrow space between the top of the long bone of the upper arm (humerus) and the overhanging rim of the shoulder blade, tissues interposed can become compressed. This leads to pain in the front and side of the shoulder, particularly with overhead movements. As the condition becomes more severe, it can cause pain at rest and shoulder weakness. Tissues most commonly involved are the rotator cuff tendons and shoulder bursa.
Those most susceptible to shoulder impingement are people who perform a lot of repeated overhead movement, such as swimmers, tennis players, electricians, and painters. Another factor, however, is gradual loss of strength of the rotator cuff muscles as well as other shoulder stabilizing muscles, which leads to impaired shoulder movement. Shoulder impingement can therefore happen to anyone.
Treatment for shoulder impingement is best determined following a comprehensive physical examination of the entire shoulder complex, upper back and neck. In addition to ruling out other causes of shoulder pain, and assessing strength and range of motion (quantity of movement), it is important to evaluate the quality of movement of the shoulder girdle. An underlying factor in the development of impingement is altered movement patterns that develop over time. Treatment then would be designed to restore balance to the shoulder girdle and improve movement health through. Specific treatment most commonly includes therapeutic exercise, modalities to control pain, and education. When repeated overhead movements are a factor, modification of activity is important. Anti-inflammatory medications can help to reduce pain, however they are not a long-term solution.
Physical therapists are the providers of choice when shoulder impingement is suspected as a cause of shoulder pain. Your physical therapist can conduct the necessary examination, and prescribe the most targeted course of care to alleviate the condition.
Marcia Spoto PT, DC, OCS