Shoulder Impingement Syndrome

What is it?

Shoulder impingement is a general term for shoulder pain caused by ‘pinching’ of any soft tissue structures which pass between the humerus (arm bone) and the top of the shoulder blade. These structures are most commonly the rotator cuff tendons and/or the sub-acrominal bursa.  It is characterised by pain localised to the shoulder and often at the front of the arm which is worse during activities at shoulder height and overhead or on reaching behind the body i.e. reaching for the seatbelt. Sometimes the rotator cuff complex can sustain tears or strains, and these can either be as a result of a sudden injury (traumatic) or happen gradually over time (atraumatic). Clinically the Physiotherapist can usually deternmine whether there is a rotator cuff tear in addition to the impingement type symptoms and this can be confirmed by a Doctor using an ultrasound scan or an MRI scan.

Causes

Common causes of this condition include weakness of the muscles of the shoulder or instability, stiffness of the shoulder, poor posture and faulty movement patterns. Symptoms can occur gradually, be as a result of trauma or be activity or sports related e.g. throwing sports or swimming.
 

Treatment

Following a thorough examination and assessment of the presenting problem, advice and treatment may include the following:

• Electrotherapy i.e. Ultrasound, TENS, Interferential to control pain and inflamation

• Acupuncture to restore normal muscle tone and control pain

• Specific joint and soft tissue mobilisations to restore normal joint biomechanics

• Assessment and treatment of neck and upper back areas which may contribute to the symptoms

• Individually tailored exercise programme to include appropriate stretching and strengthening exercises

   

Anti inflammatory medication or a steroid injection can be a useful adjunct to your physiotherapy treatment.