Do you have shoulder pain when reaching overhead to put kitchenware away, behind your back to put on a belt, or across your body when turning your steering wheel? How about when throwing a baseball or football? If so, you may be experiencing a shoulder impingement.
Most of us take pain free use of our arms for granted. They are involved in almost every activity we perform throughout the day including work tasks, carrying grocery bags, dressing, housework, and sports to name a few. However, the complexities of moving your arm means that any number of factors could lead faulty mechanics and ultimately pain and weakness. One such condition caused by faulty shoulder mechanics is known as Shoulder Impingement Syndrome.
What is Shoulder Impingement Syndrome?
We all impinge to some extent when lifting our arms overhead, however some experience pain often due to excessive impingement, known as Shoulder Impingement Syndrome. When we lift our arm, a lot must happen at the shoulder joint, including specific movements of your shoulder blade, upper arm, and collar bone all in unison to for smooth pain free motion. If these specific movement, primarily controlled by your muscles, do not occur, rotator cuff tendons, ligaments, and bursa can become pinched or compressed within the shoulder.
What Causes Shoulder Impingement Syndrome?
The answer to this question can be quite complex and may require a trained Physical Therapist to evaluate and discover the root of the problem. However, a more basic answer typically boils down to 3 common reasons:
Your shoulder blade sits on top of the back sides of your ribs which are attached to the thoracic spine. If you are hunched forwards in the upper back and spine, known as kyphotic posture, your ribs are also hunched forwards causing your shoulder blades to also lean forwards and often elevate. This positioning limits the ability of your shoulder blade to tilt backwards and upwardly rotate as needed to lift your arms. Therefore causing excessive pinching within the shoulder joint.
There are many muscles that attach and affect shoulder movement, all contributing to normal movement patterns when we use our arms. If these muscles are not balanced with the correct proportion of strength and length to ensure normal mechanic, your arm or shoulder blade may be pulled out of position causing excessive pinching within the shoulder joint.
Overuse of the Shoulder
As mentioned earlier, we all impinge to some extent. While this may be okay and pain free on occasion, excessively repetitive impingement can cause tissue damage due to wear and tear. This can happen in a number of ways which can include a job that requires repetitively moving the arm into a compromised position or beginning a new activity such as painting a room or an overhead throwing sport for which the muscles are not prepared.
How Do I Treat Shoulder a Impingement?
The first thing to do when you suspect pain due to an impingement is to decrease or stop the aggravating behavior. If you are able to link any new or old activity to the onset of your pain, you should not continue because doing so will cause further damage and prolong recovery. Secondly, check your posture. Try to avoid rounded shoulders and forwards head posture as often seen when working at desks, driving etc. and avoid slouching when standing or sitting. This allows better positioning of your arm and shoulder blade for improved mechanics.
MOST IMPORTANTLY, due to the complex nature of the shoulder joint and it’s mechanics, you should contact your Physical Therapist for a comprehensive evaluation. During the evaluation, you can expect your Doctor of Physical Therapy to:
- Take a thorough history and determine when you impingement syndrome began and why.
- Assess posture and suggest corrections.
- Evaluate range of motion of the shoulder and surrounding joints/spine
- Determine muscle strength imbalances through the whole body that may be contributing
- Create a plan of care which empowers you to correct your movement patterns and eliminate this pain for good.