Shoulder impingement (AKA Subacromial pain syndrome) is a term that most of us have probably heard thrown around in casual conversations about sports injuries or the need for a good shoulder massage after a long day at the office. But what is it, really? Is it something to worry about, or is it just another way of saying one’s shoulders are feeling a little “creaky” or pinchy” with movement? In this blog post, we will dive deep into shoulder impingement, exploring its diagnosis, anatomy, causes, recovery time, corrective exercises, and ways to prevent it from becoming a recurring nightmare. Let’s get started

The Anatomy of the Shoulder: A Quick Understanding

To truly grasp the concept of shoulder impingement, we need to paint a picture of what the shoulder actually looks like. Imagine an intricate ballet performance – it’s all about the joint mechanics. The shoulder is composed of three primary bones: 1. Clavicle (collarbone)-The connector of your shoulder blade to your ribcage. 2. Scapula (shoulder blade) – This triangular flat bone is where a lot the shoulder stability happens. 3. Humerus (the upper arm bone) – The hardware that connects the elbow to the shoulder. These bones are held together by a network of muscles, tendons, and ligaments, creating a joint that is both mobile and stable. Naturally, when you lift your arm, the humerus needs to glide smoothly in the shoulder joint. The smoothness of overhead movement is accomplished by the padded connection of the bursa (fluid filled sac) under one of the rotator cuff muscles (supraspinatus) that facilitates the lifting motion of the arm. Unfortunately, shoulder impingement can disrupt this ballet delicate dance of joint and tissue coordination. 

Diagnosing Shoulder Impingement: What to Expect 

If you’re experiencing persistent shoulder pain that feels like you’ve offended a particularly touchy nerve, it’s time to take action. Here’s a laid-back approach to diagnosing shoulder impingement. 1. Medical History: Your healthcare provider will ask about your symptoms, activities, and whether you’ve indulged in any questionable movements lately that may have offended your shoulder. 2. Physical Examination: Here’s where the professional shows off their skills! They’ll test your range of motion, strength, and utilize orthopedic testing to see if the arm can tolerate all this shoulder drama. 3. Imaging Tests: If your provider deems necessary, they may recommend X-rays or MRIs. It’s like sending your shoulder on a field trip! X-rays can reveal bone spurs and other irregularities, while MRIs help to identify soft tissue issues such as rotator cuff tears or excessive tissue compression. Once all the pieces are in place, you and your healthcare provider will put your heads together to devise a treatment plan. Spoiler alert: You might be a little surprised that your shoulder’s mood swings won’t be cured with a few shots of liquid courage.

Causes of Shoulder Impingement: What’s Going On There? 

Now that we understand the anatomy and diagnosis of shoulder impingement, let’s delve into what causes this mischievous condition. Spoiler alert: Logically speaking, it’s often the result of repetitive overhead movements, which can happen in various occupations or sports. 1. Repetitive Activities: Sports like swimming, baseball, painting, overhead installation, or even an intense yoga session involving downward dog poses can lead to wear and tear on the shoulder’s soft tissues. Every time your arm is raised overhead, it’s performing a delicate balancing act. Multiple missteps causing joint decentration and you have impingement! 2. Poor Posture: Picture sitting at your desk with your shoulders slouched forward, neck craning intently toward the screen. This can alter the alignment of your shoulder joint, making it more susceptible to impingement. The stress of ergonomically suspect workstations is not just for office workers… Many athletes are prone to this too. 3. Age: Age-related changes in the shoulder, like wear and tear or decreases in elasticity, can make you an easy target for shoulder impingement. But hey, with age comes wisdom (and a lot more stretchy pants). 4. Structural Abnormalities: Some individuals may be born with anatomical variations, such as a curved acromion (portion of the shoulder blade), which can predispose them to shoulder impingement. It’s similar to inviting that one Debbie-downer to the celebration. Bad shoulder movement can spoil the shoulder mechanics party for many anatomical parts of the shoulder. But what is actually happening when you get shoulder irritation? Whenever you feel the pain from overhead movement it is most likely that the supraspinatus (very top muscle of the rotator cuff) is being pinched by the top of the “subacromial space” where all of the tissue shoulder be moving freely. Swelling in the bursa sac under the supraspinatus pushes the stated muscle further upward and decreases room of overhead movement, pinching off this rotator cuff tissue. When the tissue gets pinched, it presents as a stabbing sensation, aching, or burning pain that radiates down the shoulder. Sometimes this pain may not be elicited with movement as it can last for hours uninterrupted if resting posture is incorrect.

Recovery Time: When Will This Shoulder Nightmare End? 

If you’re about to undergo surgery for shoulder impingement, bear in mind that the recovery isn’t a race. Patience is key here! Recovery can vary widely depending on the individual and the treatment approach. Conservative Treatment: If you’re following the path of corrective exercise, anti-inflammatory medications, heat and ice packs, you might see improvement within 3 to 10 weeks. Just remember: slow and steady wins the race! Surgical Intervention: For individuals with severe impingement that doesn’t respond to conservative treatments, surgical options may be necessary, typically involving arthroscopic surgery to repair the rotator cuff or remove bone spurs. Recovery from surgery can take around 3 to 6 months. Do not rush it; you’d want to be able to quickly raise your arm to reach that last slice of pizza without pain! In any case, maintaining a positive attitude and engaging in appropriate rehabilitation exercises can significantly reduce recovery time. Plus, think of the cool stories you’ll have to share about your battle with shoulder impingement! 

Corrective Exercises: Reversing Shoulder Impingement 

Now that you’ve survived the rollercoaster of anatomy and diagnosis, let’s get to the fun part: some exercises to help restore your shoulder to its former glory! 1. Pendulum Swings-How to Do It: Stand by a table, lean forward, and let your affected arm hang down. Gently sway your arm in small circles while holding a 5 pound kettle bell. Why It Works: This encourages joint mobility without strain, like getting a good stretch without needing to calm a squawking parrot on your shoulder. 2. Wall Angels-How to Do It: Standing against a wall, raise your arms in a “W” shape, keeping your elbows and wrists in contact with the wall. Slowly slide your arms up to form a “Y,” and then bring them back down. Why It Works: This exercise promotes scapular mobility and strengthens the rotator cuff. 3. Banded uppercuts-How to Do It: Secure a resistance band held by your hands out in front with your elbows at 90 degrees. Pull the band to tension and hold this tension while slowly moving your arms overhead. Make sure to your elbows from flaring and avoid shrugging your upper shoulders. Why It Works: Strengthening the rotator cuff is crucial for shoulder stability, giving your scapular muscles the power to show off its talents without the risk of impingement! 4. Scapular Retraction-How to Do It: Sit or stand tall, then pull your shoulder blades down and back, as if you’re trying to pinch a pencil between them. Why It Works: This helps to strengthen the muscles around the shoulder blade and improves posture, reducing the stress on the shoulder joint. Between 3 to 4 sets of 10-12 repetitions daily is recommended. If these movements are too painful to begin with, decrease repetitions until it is more manageable.

Preventing Shoulder Impingement: Keeping the Bad Vibes Away 

So you’ve recovered, and now you don’t want shoulder impingement crashing your next party! Here are some actionable tips to avoid this pesky condition from making a comeback: 1. Warm Up: Before engaging in any strenuous workout, warm up properly. Priming the tissue and increasing blood flow is important. 2. Strength Training: Stronger shoulder muscles can help stabilize the joint better, reducing the chances of impingement. Think of it as building a fortress around your shoulder. Psst! No dragons allowed! 3. Improve Posture: If you spend long hours hunched over a desk, consider getting a standing desk or take frequent breaks to stretch! Your back will thank you, and your shoulders will definitely appreciate it. 4. Cross-Training: Engage in a variety of activities to avoid overuse injuries. Who knew that being a well-rounded human being could protect your shoulders? 5. Listen to Your Body: If something feels off, don’t ignore it! Our bodies often give us subtle signs that should never be disregarded, much like how you’d want to read the weather report before going on a hike. In conclusion, shoulder impingement might not be the most glamorous injury, but understanding it can save you from the clutches of chronic pain. Through education, early diagnosis, conservative treatment, and the right corrective exercises, you can embrace a future where raising your arm isn’t met with resistance or pain. 

If you have any additional questions about shoulder impingement or would like to schedule a consultation, feel free to contact our team at Integrated Health Solutions. Let’s make shoulder impingement just a thing of the past!

Content provided by Dr. Parker Grundman