Shoulder impingement Irving Building Physiotherapy 0161 206 5328 All Rights Reserved 2018. Document for issue as handout.
What is it? Impingement means squashing or pinching. Normally there is a space between the arm bone (the Humerus) and the arch at the top of your shoulder blade (the acromion) that is maintained during movement. This is called the sub-acromial space. There are a number of structures that lie within this space. Impingement is the term used when any of these structures become painful. Can it be called anything else? Impingement has a number of different causes so can be called a number of different things. This can include rotator cuff or supraspinatus tendonopathy/ tendinitis, rotator cuff injury, bursitis, repetitive strain injury and many more. Who gets it? Impingement is a very common cause of shoulder pain. Anyone can get impingement but you are more likely to get it if you do repetitive arm movements above shoulder height as part of your job or sport/hobby. How is it treated? There are a number of treatment options. These include: Avoiding activities that cause the pain Painkillers and anti inflammatories Physiotherapy Injections Surgery What can physiotherapy do to help? Impingement has been linked to many factors including weakness in the muscles that control shoulder movement (the rotator cuff muscles), tightness round the shoulder, altered posture, and altered shoulder blade movement. Physiotherapy can help to address all of these problems by teaching you to: Strengthen muscles Stretch tight structures Improve posture Improve movement control This can be done either by seeing a physiotherapist individually or by attending an exercise class. Does physiotherapy work? 65-80% of patients with impingement will improve with physiotherapy although it can take up to 6-8 weeks before you start to see the benefit of treatment and significantly longer before you will see the long-term outcome of treatment. Will physiotherapy be painful? If your shoulder is tight then stretching the tight structures will be uncomfortable but most of the exercises your physiotherapist gives you should be relatively pain free. Painkillers can help control the pain if necessary. What happens if it doesn t get better with physiotherapy? If your symptoms do not improve satisfactorily with physiotherapy you may need further investigations (either X-rays or scans) and some people may benefit from an injection or possibly surgery. 1 2
Exercises 4 x 10 repetitions a day. 1.Sliding up the wall Stand with both hands resting on a wall and slide both hands up as far as you can without it being painful. 3. Stretching the band out to the side Stretch the band out to the side keeping your elbow bent and tucked in to your side (you can place a towel under your elbow to help you do this). 2. Weight bearing Lean as much weight you can through your arms without it being painful on a table. 4. Step up with loop of band Put your hands in the loop of band and stretch it gently outwards then step up onto the step and at the same time take your hands up above your head keeping a gentle stretch on the band. These exercises are designed to improve the strength of the control muscles around your shoulder and should not feel too strenuous or painful when you are doing them. 3 4
Notes Notes 5 6
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