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Shoulder Impingement

impingementDiagnosis: Shoulder impingement is a condition where the tendons of the rotator cuff are intermittently caught and compacted during various shoulder motions. This can cause injury to the rotator cuff tendons and/or bursa, creating inflammation and pain with movement.

Symptoms: Symptoms often include local irritation and swelling which results in tenderness of the shoulder. Pain may occur when you are raising the arm or when lowering it from an elevated position. Symptoms typically begin mild and may progress over time. Other symptoms might include:

  • Pain that is present with activity
  • Pain with lifting and reaching movements
  • Performing overhead activities
  • Pain at night
  • Often pain free when not moving shoulder.

 

Causes: Shoulder impingement can occur in the shoulder when the space between the acromion (top of shoulder) and rotator cuff narrows. This condition typically causes pain in the shoulder when the arm is raised. The acromion can rub or impinge the tendon and/or bursa, creating irritation and such pain. Causes are grouped into primary and secondary forms of impingement.

  • Primary: Structural narrowing due to decreased space at birth, osteoarthritis, or bone spurs.
  • Secondary: Narrowing due to faulty movement patterns of shoulder or soft tissue restrictions.

Our Physical Therapy Treatment: Goals of physical therapy will ultimately be to reduce pain, restore normal pain free range of motion, and allow for a safe return to all functional and leisure activities. Length of treatment and plan of care will depend on the severity of the injury, but will most commonly include:

  • Mechanical diagnoses/treatment for improved movement and pain reduction
  • Postural education and awareness
  • Shoulder and scapular stability and strengthening exercises
  • Manual therapy

Treatment will focus on educating the patient in an individualized self-treatment plan and establishing a home exercise program to further promote healing and prevention of future injury.

http://orthoinfo.aaos.org/topic.cfm?topic=a00032