The shoulder joint is made by the connection of the head of the humerus (upper arm) with the scapula (shoulder blade). It forms a ball and socket joint, allowing for a lot of movement at the shoulder, especially overhead motions. The shoulder joint is reinforced by a system of ligaments, muscles, tendons, cartilage, and a capsule. When these structures are intact or function properly, we are able to perform everyday activities without pain.
Shoulder impingement occurs when the space between the head of the humerus and the joint formed by the collarbone and the top portion of the scapula (acromion) is compromised. A fluid filled sac, called the bursa, sits between this joint and the head of the humerus. With repetitive overhead activities, the bursa can get inflamed and cause pain in the shoulder. With constant pressure and irritation in this area over a long period of time, a bone spur can also develop on the acromion and can cause injury to the rotator cuff.
- Localized pain in the shoulder, especially with overhead movements
- Referred pain into the upper arm
- Repetitive overhead motions found in sports and certain occupations (painters/ contractors, electricians, mechanics)
- Poor posture / positioning of the shoulder joint
- Other factors that cause the space to narrow, like a bone spur on the acromion
PHYSICAL THERAPY FOR SHOULDER IMPINGEMENT
Physical therapy will first aim to reduce inflammation in the shoulder. You will be advised to modify your activities to avoid aggravating your symptoms. Your physical therapist will teach you postural correction exercises to actively stabilize the shoulder blade in order to better position the shoulder joint and avoid further impingement.
Ultrasound and ice may be used to help decrease pain and inflammation, especially if associated with bursitis in the shoulder. Your therapist will also teach you exercises that will strengthen the rotator cuff and muscles that support the spine and shoulder blade. The goal of therapy will be to eventually allow you to return to the gym, work, or other recreational activities without pain.