This month I educated the team at Queen Street Physiotherapy on recent research surrounding impingement of the shoulder, also commonly known an impingement syndrome. Impingement of the shoulder is a very common condition in which we see and treat at our Queen Street clinic frequently.
Patients often report pain at the top or front of their shoulder which is often exacerbated with overhead movements, placing the hand behind the back and lifting objects. An individual may also experience weakness at the shoulder or pain referring down the arm. Impingement syndrome may arise from direct trauma to the shoulder, such as falling off your bike, or can come from repetitive movements such as gardening or lifting weights at the gym.
The above symptoms can be from various structures such as inflammation of the bursa (which is a closed, fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body) or irritation to the tendons of the rotator cuff muscles. If impingement symptoms are not addressed thinning and wear and tear of the tendons may take place or rotator cuff muscles may further tear. Impingement syndrome has been reported to last up to three years in 50% of people who do not seek treatment so it is important to address pain at the shoulder as soon as possible.
Physiotherapy can help by firstly diagnosing the underlying cause for the impingement. Hands on manual therapy can then be utilised to reduce muscle tension, mobilise stiffness of underlying joints and to stretch or lengthen the deep shoulder capsule which can give rise to pain. A home based stretch and strength exercise program to retrain the effected muscles or tendons is then implemented. Additional physiotherapy modalities such as ultrasound, TENS and dry needling can also be employed to assist this injury.