12 Apr What is shoulder impingement?
Do you have pain in your shoulder when reaching overhead or across your body? Maybe when you put on a shirt over your head or put a bra on? You may be experiencing shoulder impingement syndrome symptoms. There are many conditions that can create this pain. Primary impingement is due to structural abnormalities of the shoulder blade while secondary impingement is due to repetitive activities with overuse of smaller muscles and under-activation of the bigger shoulder blade muscles.
So what exactly is impingement syndrome? In the shoulder, which is a ball and socket joint, there is a small space for things such as tendons and bursae that run in between the “ball” and the “socket” portions. When that space is decreased due to inflammation or a structural abnormality such as a bone spur or genetic formation of your shoulder blade, the structures inside can get ‘pinched’ with certain movements; specifically when reaching above your head or across your body.
What can be done?
First determine the cause of the inflammation:
Rotator Cuff Injury: Acute: from a specific mechanism of injury; or Chronic: overuse of smaller rotator cuff muscles with under-activation of larger shoulder blade muscles
Other pathologies include Bursitis, Labral Tear, Decreased shoulder stability, Biceps injury, Bone spur/structural abnormalities
Then decrease the inflammation:
1. Rest: modify your activities to avoid painful motions. No pain no gain is not the motto here.
2. Ice: 20 minutes as often as possible
3. Medications: anti-inflammatories
4. Injections: if the above three and therapy cannot control the pain
See a physical therapist for muscle imbalance
1. Reactivate shoulder blade musculature
squeeze shoulders “down and back” without sticking your chest out to help ‘clear’ some space for the structures pinched and gain strength the the musculature
Exercises good for the gym: Rows, Shoulder extensions
2. Reactivate rotator cuff musculature and strengthen:
There are 4 rotator cuff muscles that each perform different actions, however all depress the ‘ball’ of the arm bone thereby increasing the space in the joint.
Exercises: Scaptions: raise your arm upwards in a ‘v’ shape to 90 degrees.
Shoulder External Rotation: sidelying
Shoulder Internal Rotation
3. Stretch tight musculature surrounding the shoulder: Pecs, Levator scapulae
Begin with these pain-free exercises in combination with activity modification and reduce the inflammation to see the best results.