Aches and Pains in the Shoulder are one of the most annoying pains that you can have – affecting your sleep, activities like driving or even brushing your hair.
One of the most common forms of shoulder pain involves the pinching of the tendons in the point of the shoulder, commonly known as Shoulder Impingement.
THE SHOULDER JOINT
The Shoulder joint is complex.
Whilst it is really a simple ball and socket joint – the socket that houses the ball is very flat and shallow. This means that there is not much stability provided by the shape of the socket to stop the ball moving around.
In all movements of the shoulder, particularly when raising the arms, the biggest muscle on the side of the shoulder (the deltoid muscle) contracts to raise the arm, and in doing so wants to force the ball of the shoulder joint upwards in the socket.
What stops the ball moving too far upwards in the socket are an intricate arrangement of small muscles called the rotator cuff, which constantly adjust their tension to pull downwards, and keep the ball centred in the socket.
WHAT CAUSES SHOULDER IMPINGEMENT?
Shoulder Impingement can occur when there is an imbalance of the two opposing forces of the upwards pull of the deltoid and the downwards pull of the rotator cuff.
If there is a reduction in the pull from the rotator cuff, the small space that exists above the ball between the ball and the top of the shoulder socket being narrowed.
This can cause pain, swelling and bruising of the rotator cuff tendons, or the bursa that sits between the tendons and the top of the socket. This can lead to inflammation of the bursa (known as bursitis) or even damage to the tendons.
SO WHAT CAN WE DO TO TREAT SHOULDER IMPINGEMENT?
Well the first thing we need to do when assessing patient with Shoulder Impingement is to thoroughly assess the function of your shoulder.
Part of this will be to determine if there are any imbalances in the muscles supporting the shoulder that may be contributing to the pain.
We also look at the flexibility of the muscles around the shoulder – tight muscles around the back of the shoulder can also force the ball upwards in the socket and contribute to impingement.
Once we’ve worked out the cause of your impingement, the management of Shoulder Impingement probably has three phases.
Phase 1 – Reduce Pain And Swelling In The Area
Treatment can include ice application and anti-inflammatory medication from your GP to help reduce any swelling or inflammation of the structures in the impingement area that are getting caught.
Phase 2 – Rectify Strength And Flexibility Imbalances
We generally provide a series of simple home exercises to improve your rotator cuff function and to improve the flexibility of the tight muscles in your shoulder
Phase 3 – Resumption Of Activity
One the pain and inflammation has settled and the shoulder function has been restored, we guide our patients through a safe reintroduction back into their activity – no matter if it is putting clothes on the line, or serving at tennis.
So, if you have shoulder pain right now, We’d suggest that you:
Avoid any activities overhead
Avoid lying on the sore side
Apply ice packs for 15 minutes intermittently
Plan to see your GP or your physiotherapist for an assessment.
If the diagnosis is shoulder impingement, be assured that there are plenty of great treatments that can be performed to help your symptoms – and at Leading Edge Physiotherapy, we are more than happy to help you get rid of your shoulder pain.