Shoulder impingement syndrome occurs when the top outer edge of the shoulder blade (the acromion) compresses the rotator cuff and the other structures of the shoulder joint beneath it. This action causes sharp pain and inflammation, which further narrows the space. The quickest way to get relief from such pain is usually applying ice, anti-inflammatory drugs, cortisone injections, or in worse cases, surgery. However, addressing the underlying cause is important and this is where physiotherapy can help you. Furthermore, exactly how to fix shoulder impingement syndrome depends on the level of your shoulder pain and the nature of the underlying cause of the problem.
How does shoulder impingement develop?
The shoulder’s so called “rotator cuff” passes through a small space underneath your acromion, which is the bony tip of the scapula (shoulder blade) that comes off the scapula’s top side. Here, this bony tip meets with the collar bone at the shoulder. Shoulder impingement occurs when the tendon rubs against the acromion.
The causes of shoulder impingement syndrome include:
1. Torn or swollen tendon
Most of these cases result from overuse or over-exposure to resistance training or shoulder activity, shoulder injuries, or age-related wear and tear.
2. Irritation or inflammation of the bursa
The bursa is a fluid-filled sac lying between the tendon and the acromion that lubricates the muscles and tendons during movement. When this region is inflamed, as a result of overuse or an injury, it could subsequently lead to shoulder impingement syndrome.
3. Birth defects or Wear and Tear
If you are born with an acromion that is not flat or develop age-related bone spurs on your acromion.
Symptoms of shoulder impingement syndrome
The following can be clues that you are suffering from shoulder impingement syndrome:
- Pain when you try to lift or extend your arm above your head.
- Tenderness and pain in the front of your affected shoulder.
- Sharp pain originating from the front side of the shoulder to the side of the arm.
- Sharp pain when lying on your afflicted shoulder.
- Pain when reaching behind your back, like reaching into a back pocket.
How to fix shoulder impingement syndrome
Shoulder impingement syndrome can be treated using various approaches depending on the severity of the pain and the situation as a whole. Approaches include:
Stretching exercises to improve the shoulder’s range of motion is one of the most important remedies for shoulder impingement. The shoulder is an extremely unstable joint and depends on the muscles around it to maintain stability. An imbalance in these muscles predisposes the shoulder to all sorts of problems. Your physiotherapist will devise a program of care that will ensure the shoulder function is rehabilitated as fully as possible.
2. Ice therapy
Physiotherapists sometimes apply this approach to assist with pain relief in the short term. For the best results with ice therapy, you should apply ice on the affected area for 20 minutes twice a day to reduce the inflammation.
3. Pain medication administration
How to relieve shoulder impingement pain depends on your healthcare provider. They could prescribe naproxen or ibuprofen to relieve the pain caused. Doctors often prescribe stronger pain medications coupled with anti-inflammatory drugs whenever the pain is severe and unbearable. However, remember painkillers and anti-inflammatories simply reduce the symptoms. Rehabilitation is required for you to fix the underlying problem.
4. Avoiding physically challenging activities
You may be advised to avoid activities that demand them to reach over the back or heavy resistance training at the gym to give the shoulder enough time to heal.
If non-surgical approaches fail to provide permanent relief, subacromial decompression surgery is the last resort. The surgery provides adequate space for the rotator cuff by removing the part of the acromion. The procedure involves making small incisions in the affected shoulder and physically cutting part of the acromion. Thankfully, rehabilitation can often avoid the need for surgery. However if surgery is needed, before and after shoulder muscle strengthening and rehabilitation will help you get the best results from surgery.
Fixing shoulder impingement syndrome might require a bit of effort. However, the results are well worth it. If you need help with shoulder pain, give us a call on 03 9034 7735 or click to book an appointment online.