How do you fix shoulder impingement?

Shoulder impingement is a common condition that causes pain around the front of the shoulder and upper arm. Impingement is a broad umbrella term commonly includes conditions such as shoulder bursitis or shoulder tendonitis. Symptoms can range from a dull ache around the shoulder that is exacerbated with arm movements. When not managed properly, it can commonly lead to reduced strength and flexibility resulting in further discomfort and disability. Our physiotherapist Jason Lee examines common ways to identify if you are experiencing shoulder impingement and what you should do to address this condition.

What is shoulder impingement?

The shoulder is an incredibly mobile ball and socket joint. The general shape of the joint is similar to a golf ball on a tee with very poor joint congruence and stability. This lack of congruence is incredibly valuable allowing our arm to move in a wide variety of directions and angles.

Shoulder impingement occurs when soft tissue structures such as the tendons of the rotator cuff or bursa become inflamed and painful. This includes shoulder tendonitis, bursitis and rotator cuff tears.

Common symptoms include a dull ache at the front of the shoulder that is exacerbated with overhead movements. As the condition progresses, symptoms can include a loss of strength, weakness and decreased flexibility.

How to treat shoulder impingement?

Our team at Malvern East Physiotherapy treat many people who have experienced shoulder impingement. Physiotherapy has been shown to be one of the most effective methods to treat shoulder impingement. In fact, physiotherapy has been shown to be superior than a corticosteroid injection.  Research has shown that a combination of hands-on physiotherapy and specific exercises has been shown to be the optimal treatment for impingement with long term results at both 4 weeks through to 3 months.

To reduce pain associated with shoulder impingement, your physiotherapist may utilise a range of hands-on techniques including shoulder mobilisations, dry needling or massage. In some cases, treatment may also address upper back and neck tightness that can be commonly associated with long standing shoulder pain. Most importantly, exercises to target strength specifically to the rotator cuff and around the shoulder blade are crucial to regain mobility, flexibility and strength. These exercises should be tailored and individualised depending on the nature and severity of your shoulder pain.

Exercises for shoulder impingement

Exercises for shoulder impingement should be targeted specifically at strengthening the rotator cuff and shoulder blade. These exercises can commonly include theraband exercises through to resistance exercises using weights. In some cases, clinical pilates or clinical strength can be a safe and effective way to address your shoulder pain.

Mobility exercises to address the upper back and neck can also be important for those with long standing shoulder pain. Upper back mobility is important to allow normal shoulder biomechanics whilst neck stiffness and tightness can often be associated persistent shoulder pain.

Does a cortisone injection help shoulder impingement?

Corticosteroid injections have commonly been utilised in the management of shoulder pain and impingement. Whilst corticosteroid injections can be effective in managing pain, it is important to consider all options. Current research indicates cortisone injections provide short-term pain relief but can have long term consequences. In fact, we now know that cortisone has negative effects on the structure of the tendon and actually predisposes the tendon to a higher risk of rupture.

However, in cases where progress has plateaued, corticosteroid injections may have a good effect to allow rehabilitation to progress. Your physiotherapist is well placed to discuss whether an injection can assist your rehabilitation.

If you are experiencing shoulder impingement, contact Malvern East Physiotherapy. Our team will comprehensively assess you shoulder and develop a specific treatment plan for you. Contact us today or book online today.