Have you ever had a pinching sensation in your shoulder when you reach your arm overhead or about halfway while you are lifting your arm up? That’s called shoulder impingement.
What Is Shoulder Impingement
This injury occurs when the rotator cuff muscles are being rubbed by the acromion. When the rubbing happens, it can lead to inflammation and the space in the shoulder joint narrowing.
Let’s break down this definition a little more. The rotator cuff muscles support the shoulder and balances the head of your humerus in place. The acromion is the top of your shoulder blade or the bony part you feel on the top of your shoulder. One of the rotator cuff muscles, the supraspinatus, glides through the area underneath the acromion. When you do something repetitive with your shoulders, that muscle can become irritated. It can particularly become irritated for those who do overhead sports, or swimming, or do repetitive overhead reaching in their daily life.
My Experience With Shoulder Impingement
I have experienced this injury before and it’s pretty uncomfortable. This injury for me came from playing a lot of tennis and then travelling while having a really heavy bag on my right shoulder. My shoulder got super inflamed that leading to shoulder impingement.
Common Treatments For Shoulder Impingement
- Resting and ice
- Physical therapy
- Injection
- Surgery
Why Physical Therapy And Rest and Ice Are The Best Options For Shoulder Impingement Injury
Based on my physical therapy practice, we have a number of things that we do to treat shoulder impingement so that it can be treated naturally as the injured area recovers.
First, we try to get the patients to move their arm through that range of motion without any pain. They usually feel the pain when they are lifting their arms sideways and halfway through, that’s when they get the pinching sensation. Sometimes, they also feel the pain when their arms are all the way over their head. So, we try to keep the load low and start to move through that range of motion so that the brain will start to feel safe to move the injured area. Once the brain feels safe, the pain and inflammation process will decrease and patients will naturally get more space in the affected joint.
Next, we perform joint mobilizations to the shoulder. This process helps create more space in the joint so that when patients reach their arms over their head, they won’t get that pinching sensation. It also helps calm the nervous system down. Through joint mobilization, patients are brought into the edge before actually feeling the pain. With this process, the brain will realize that it’s safe to go through that motion so the pain will eventually start to decrease.
Another thing that we ask our patients to do once they get that range of motion with decreased pain is to begin to strengthen their rotator cuff muscles. With shoulder impingement, patients aren’t using their arms quite as much, so they need to get their rotator cuff muscles to work again in a way that they can coordinate the motion of the shoulders and decrease the pain they are feeling.
Also, we ask patients to strengthen their muscles between their shoulder blades. Through this strengthening, they can put their shoulders in a better position when they lift their arms up and down and over their head. This will also help decrease the pain.
Lastly, we ask our patients to get back into their activities. We ask them to slowly get back into their activities as with any other injury. For example, for those who play tennis and suffered from shoulder impingement injury, I ask them to go back to the tennis court to play for 20 minutes and only use ground strokes. This way, it’s less likely to cause them any pain during the session. After that, if they feel good the next day, they can go a little bit longer until they can play for 40 minutes straight. From there, I share with them some ways to warm up their shoulders so they can start hitting serves again.
Usually, if you treat shoulder impingement injury through physical therapy, it takes about four weeks. That’s not very long to decrease the symptoms and the pain.
As for rest and ice, it is a great way to go. However, you need to make sure you are doing the strengthening activities so you prepare your body to get back into your activities once you recover.
Why Surgery Is Not The Best Option For Shoulder Impingement Injury
Although surgery is one of the suggested solutions for shoulder impingement injury, it is not really necessary. There have been research studies that back up this statement.
Usually during surgery, what they do is they shave the acromion down a little bit to create more space in the shoulder. However, this is problematic because if you have inflammation, the problem is going to continue to occur. There will be less space in the joint so you will continue to get that pinching sensation.
It also takes you a while to get an appointment with an orthopedist and you would have to undergo an MRI, which is expensive. Once they see your results, they will schedule you for surgery. This could already take four weeks just waiting for surgery and more time for the pain to go away. There is even no guarantee that the pain will go away after the surgery. Most of the time, you will have to go to a physical therapist to help you recover after surgery.