Shoulder impingement is one of the leading causes of shoulder pain and discomfort among the general population. It can exist in conjunction with other injuries to the shoulder or independently. Impingement commonly manifests as a result of overuse and long term repetitive activates involving the shoulder. In most cases, the tendon of the supraspinatus muscle or the sub-acromial bursa are becoming pinched. While it is possible for other tendons of the rotator cuff to become impinged, this is fairly uncommon. Risk factors for impingement syndrome include shoulder instability or weakness, sports/occupations that include repetitive micro trauma to the shoulder such as painting, plumbing, overhand throwing, swimming and more. Poor posture also predisposes individuals to developing impingement syndrome due to the forward position of the scapula. When we slouch forward, the structures under the acromion are in a vulnerable potion to becoming pinched. To avoid this, practice keeping both ears positioned in the same upright position as your shoulders. This will encourage the shoulders to stay back in a more neutral position.
Shoulder impingement symptoms typically start with mild pain and discomfort felt at the anterior, or front of the shoulder joint. As the injury progresses, this leads to reduced range of motion in the effected shoulder with increasing duration and severity of pain. One of the hallmark signs of shoulder impingement is pain felt when raising arms out to the side between 70-120 degrees. Pain is often described as dull/achy and in some cases ‘pinchy’.
In order to help revolve this issue it is crucial to strengthen the muscles of the rotator cuff. This will result in improved stability and function of the shoulder joint. When the muscles of the rotator cuff are weak, this leads to laxity of the shoulder joint which prevents our humerus from gliding downward in the joint. When the humerus does not glide downwards, as we raise our arm overhead, it literally bumps into the superior aspect of the scapula known as the acromion. The tendon of the supraspinatus muscle, and the subacromial bursa lie between these two structures and are being pinched as you lift arm overhead. Overtime this leads to chronic pain, irritation to the tendon, and detrimental compensatory patterns.
Posture correction is a vital aspect of care in order to improve the resting position of the scapula, thoracic, and cervical spine. When the shoulders are rolled forward, this predisposes us to impingement. Performing a proper exam is an important step to tailoring an effective treatment for each individual. Treatment in office typically includes deep tissue work to the soft tissues of the shoulder to help improve mobility as well as adjustments and mobilization to the entire shoulder region and spine, followed up by home care exercises to help improve the overall function and stability of the shoulder. The goal is to not only resolve the issue, but also prevent it from coming back! Conservative management including chiropractic care is extremely effective for treating shoulder impingement. If this sounds like something you are experiencing, come see how we can help!