Shoulderimpingement and the Role of Physiotherapy: Causes, Symptoms, and Treatment

Shoulder impingement can be a significant burden for individuals, leading to considerable pain and restricted mobility. In this blog post, we will delve into the causes and development of impingement, its symptoms and consequences, and the role of physiotherapy in its treatment. Additionally, we will introduce some alternative exercises that individuals can perform at home to alleviate their discomfort.

Causes and Development of Shoulderimpingement:

Shoulder impingement occurs when the space between the shoulder roof (acromion) and the upper arm bone (humerus) becomes narrowed, resulting in friction and entrapment of tendons. This can be caused by various factors, including:

1. Poor Posture:

Poor posture can lead to abnormal shoulder alignment, narrowing the space within the shoulder joint, and increasing the risk of impingement.

2. Overuse:

Repeated movements, particularly those requiring overhead positions such as throwing or swimming, can overload the shoulder tendons and cause impingement.

3. Muscle Imbalances:

Weaknesses or imbalances in the muscles surrounding the shoulder can alter movement dynamics and increase the risk of impingement.

Symptoms and Consequences of Shoulder Impingement:

The symptoms of shoulder impingement can be diverse, including:

– Pain when lifting the arm laterally or performing overhead tasks, especially in the shoulder and upper arm region.
– Restrictions in movement, manifesting as difficulties in lifting or moving the arm.
– Loss of strength in the arms due to shoulder pain, leading to impaired function.
– Pain radiating into the upper arm, mostly on the outside, along with possible discomfort when lying on the affected shoulder.
– Unnatural joint sounds such as grinding or popping during shoulder movement.

Untreated shoulder impingement can result in chronic pain, tendon inflammation, and even impairment of shoulder function.

The Role of Physiotherapy in Shoulder Impingement Treatment:

Physiotherapy plays a crucial role in the treatment of shoulder impingement. A physiotherapist can conduct a comprehensive assessment of the shoulder to identify the exact causes of the discomfort. Based on this assessment, an individualized treatment plan may include:

1. Manual Therapy:

Targeted manual techniques can release tension, improve mobility, and promote blood circulation.

2. Strengthening and Stretching:

Specific exercises to strengthen the shoulder muscles and improve mobility help reduce shoulder stress and alleviate symptoms.

3. Posture Correction:

A physiotherapist can assist in achieving better body posture to reduce shoulder strain and promote healing.

4. Patient Education:

Educating the patient on how to protect their shoulder in daily activities and which activities to avoid to prevent further exacerbation of symptoms.

Self-Treatment Exercises for Shoulder Impingement:

1. Pendulum Exercises:

Lean on a table or chair with the unaffected hand and let the affected shoulder hang loosely. Move the shoulder in small circular motions forwards and backward.

2. Fascia Rolling Massage:

Use a foam roller to massage the muscles around the shoulder and release tension. Roll gently over the area, focusing on painful spots.

3. Shoulder Blade Stabilization Exercises:

Stand with straight arms against a wall and press your shoulder blades firmly against the wall. Hold the position for a few seconds and repeat several times.

4. Isometric Shoulder Exercises:

These exercises strengthen the muscles around the shoulder without causing joint movement. An example is isometric lateral abduction: Stand upright and press the palm of the affected side against a wall while lifting the arm laterally from the body. Hold the tension for 5-10 seconds and repeat several times.

5. Door Stretch:

Stand sideways next to a door with the affected shoulder facing the door. Place the hand of the affected side on the door handle or edge at shoulder height. Lean forward slightly to feel a stretch in the chest and shoulder muscles. Hold the position for 30 seconds to 1 minute and repeat on the other side.

6. Shoulder Blade Stabilization Exercises with Theraband:

Attach a Theraband to a stable surface at chest height. Hold the band with both hands and pull the shoulder blades together while pulling the band apart. Hold the tension for a few seconds and return to the starting position. Repeat this for several repetitions.

7. Towel Roll Exercise:

Roll a towel into a long, firm roll and grip it with both hands. Hold the towel in front of you at shoulder height and pull the shoulder blades back and down while pulling the towel apart. Hold the tension for a few seconds and repeat several times.

8. Shoulder Circles:

Stand upright and relax your arms at your sides. Perform slow and controlled circular movements with your shoulders, first forwards and then backward. Try to gradually increase the range of motion without causing pain.
It is important to perform these exercises slowly and cautiously, stopping immediately if you experience pain. Overall, shoulder impingement is a common issue that can often be effectively treated with targeted physiotherapy and self-treatment. By paying attention to your shoulder health and regularly performing exercises, you can alleviate your symptoms and improve your quality of life.