Shoulder Pain – Impingement
Impingement is a term used to describe a wide range of rotator cuff abnormalities occurring in the shoulder. It is a condition where the rotator cuff tendons of the shoulder can become intermittently trapped and compressed during shoulder movements.
There are 2 types of impingement syndromes:
1.Primary External impingement involves structural changes to the acromion resulting in the subacromial space becoming smaller. This smaller space may cause compression and irritation of the rotator cuff tendons and bursa.
In the older population thickening of the coracohumeral ligament may also reduce the subacromial space leading to shoulder pain.
2.Secondary External impingement occurs as a result of a dysfunction/unstable shoulder during arm movement. This is often seen in people who have had an acute trauma, poor posture and those who carryout repetitive overhead movements.
- An arc of shoulder pain when lifting arm is at/near shoulder height and when overhead.
- Pain on reaching behind your back or head.
- Pain on lying on your painful shoulder.
Treatment: Depending on what your Physiotherapist has established during their assessment will determine your course of treatment. There are many structures that are involved in shoulder impingement syndrome.
- Acute/Early Injury – pain relief is important as it may affect your rehabilitation process.
- Regain full painfree shoulder movement.
- Restore normal scapulo-humeral rhythm and control.
- Restore rotator cuff strength and flexibility.
- Restore normal neck, scaupulo-thoracic and shoulder function.
- Restore speed, power and proprioception to shoulder complex.
- Return to sporting activity.
Recovery: Every injury is different, some will respond effectively to one treatment session, a more complicated injury may require more time. This can take between a few weeks – months. Others may require surgery for when non-operative treatment has not been effective.
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