A relatively common cause of shoulder pain, shoulder impingement occurs when a tendon in the shoulder catches on a nearby bone or on the surrounding tissue – it usually occurs when the arm is lifted above the shoulder or moved. The shoulder joint plays an important role during movement – any type of pain felt in the shoulder can make us acutely aware of just how much the shoulder is involved in almost every activity that we do.
The shoulder itself has three main bones; the clavicle, scapula and the humerus – these are surrounded by tendons and other soft tissue. Impingement or compression typically occurs when one of the tendons becomes irritated or suffers some sort of trauma. This causes the tendon to become inflamed or harden and impinge on a nearby bone or the surrounding tissue and subsequently resulting in painful symptoms, which often worsen when the arm is lifted.
Often shoulder issues will improve on their own with rest and recuperation, however sometimes this type of disorder can become chronic. This can seriously hinder everyday life and activities – simple routines such as bathing and getting dressed can be painful and difficult, it can also be nearly impossible to practise any type of exercise or participate in sports or other physical activities.
The symptoms experienced may vary from individual to individual but typically include pain around the top and the sides of the shoulder. Some people may experience a continuous aching sensation which may get worse at night. Restricted movement of the arm and upper torso is also common, and a sharp pain is often felt when the arm is lifted above the head. Numbness in the arm itself can also occur if nerve compression is present.
Shoulder impingement may be the result of a number of potential causes, it is, however, heavily associated with repetitive actions seen in manual labour jobs and particular sports and activities including, weightlifting, tennis, volleyball, swimming, golf and so forth. The repetitive action of particular movements can cause excessive strain to the structure of the shoulder joint, resulting in local inflammation amongst the soft tissues.
Shoulder impingement can also occur as a result of a prior injury or trauma to the shoulder joint.
During diagnosis, a physiotherapist or a GP will assess the symptoms and try to rule out any other potential disorders. They will do this by undertaking a detailed investigation regarding the pain and other symptoms, the individual’s occupation and lifestyle habits (sports and exercises etc.) as well as any activities which have been difficult to perform due to the pain in the shoulder. The more information provided during diagnosis, the greater the chance of determining the symptoms accurately. In some cases, an X-Ray or an MRI may be necessary to rule out any other conditions.
Shoulder Impingement Treatment
Initially, it may be worth trying to settle the symptoms with rest, ice and over the counter painkillers such as paracetamol or ibuprofen and refraining from any activities which may have provoked the pain. In the case of persistent symptoms, it is a good idea to consult a physiotherapist or a doctor – the GP may then refer for physiotherapy.
Physiotherapy provides a holistic approach to treatment, this means that the physiotherapist will take into consideration the individual’s lifestyle, occupation, habits, and general wellbeing when assessing the symptoms during diagnosis. It is a highly effective type of treatment for shoulder impingement and indeed other disorders of the shoulder – physiotherapy treatment can be loosely divided into three main categories:
- Hands-on manipulation and massage techniques
- Prescribed movement
Specific exercises can be prescribed to help to improve posture and technique during any type of exercise or movement which may be aggravating the symptoms. Hands-on manipulation may also be required. The physiotherapist will also discuss self-care techniques and how to prevent further symptoms – this may include lifestyle changes and changes to posture. Other physiotherapy techniques may include ultrasound and laser.
If rest and exercise have not helped to relieve painful symptoms, then a steroid injection may be considered, this helps to treat inflammation and promote healing. The injection itself typically consists of a mixture of local anaesthetic and steroid, administered into the back of the joint. It may be initially painful, and symptoms can in some cases even worsen within the first 24 hours following application. In general, no more than three injections are administered each year.
How We Can Help
ProPhysiotherapy offers a wide range of physiotherapy related services designed to treat a vast selection of disorders and injuries including shoulder impingement. Our treatments are based on established techniques that are supported by research – all treatments are tailored to suit the individual’s needs or symptoms. For more information on our services, get in touch today.