What is it?
Shoulder impingement syndrome is a common cause of shoulder pain that can affect both men and women. When your arm is in an overhead position, the “sub-acromial space” (i.e. the gap between the “acromian” of the shoulder blade and the head of the humerus bone) gets smaller. As a result, the space available for soft tissue structures to pass through this region narrows. Three major structures that travel through this gap include one of the rotator cuff tendons (known as the “supraspinatus”), the long head of the biceps tendon and the sub-acromial bursa. With repetitive overhead activity these structures can wear down, become inflamed and even develop small micro-tears overtime resulting in shoulder pain.
What are the signs and symptoms?
The symptoms of shoulder impingement syndrome include pain in the front and/or side of the shoulder which can often radiate down the arm. People often complain of pain at night and pain that is worsened by lying down on the affected side. Symptoms are often exacerbated with movements above shoulder level such as combing you hair or putting away dishes on a shelf. Weakness and loss of range of motion are also common signs of impingement syndrome which can cause difficulty when lifting your arm overhead or carrying heavy objects such as groceries.
Why does this happen?
Although shoulder impingement can result from specific trauma to the shoulder, most often this condition develops gradually over weeks to months due to overuse. There are many reasons why someone could develop this injury such as repetitive overhead activity and/or poor scapular strength and stability. Sports and activities such as volleyball, baseball, swimming, tennis and painting, all require repetitive arm movements which can cause overuse to the rotator cuff and biceps tendon and pain overtime. In addition, poor posture where your shoulders slump forward as well as the development of bony spurs within the shoulder can also cause narrowing of the sub-acromial space which can lead to impingement syndrome.
Can I fix this problem?
Shoulder impingement typically responds well to conservative treatment which includes resting from aggravating activities and an individualized physiotherapy exercise program to improve shoulder strength, range of motion and scapular control. Treatment may also include deep tissue/friction massage, athletic taping, acupuncture and the application of heat/ice as appropriate. If left untreated, shoulder impingement symptoms can continue to worsen and may result in larger rotator cuff tears over time. Consult your healthcare practitioner for more information on shoulder impingement and to learn what they can do to help you.
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Written by: Vanessa Younes, MScPT
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