PATIENTS GUIDE TO SHOULDER IMPINGEMENT SYNDROME 
Introduction The shoulder is a complex bit of anatomy. I equate it to a golf ball (arm bone or humerus) on a golf tee (shoulder socket or acetabulum). It is a ball and socket arrangement but the socket is small and the ball is fairly big. This means patients have a lot of flexibility in the shoulder if all is going well. The shoulder has a lot of range of motion. It comes in handy for combing their hair or reaching behind them for their wallet. Unfortunately this flexibility also has a down side. Anything that is this flexible can also be highly unstable and prone to injury. The purpose of this article is to help you understand when one of these problems, “impingement syndrome” occurs. Anatomy If you look at illustration #1.) Shoulder Impingement you can see where the arm bone (humerus) ‘hits’ or impinges on the acromium of the shoulder blade when you reach overhead. The ‘cure’ is to stretch the muscles pulling the humerus into the acromium and strengthen the rotator cuff that hold the ball of the humerus in the socket of the shoulder blade; see illustration #2) Rotator Cuff Muscles, on page two. Symptoms What does impingement syndrome feel like? It feels like a generalized ache in the shoulder in the earlier stages. It causes pain when patients reach their arms up and out to the side, especially with the palm turned down. Most of these folks complain of pain in the shoulder at night when they try to sleep, especially when they roll on the sore shoulder. Another sign of shoulder impingement is a pain in the shoulder when patients try to reach into their back pocket or reach behind for their bra fastener. As the syndrome goes on the pain and discomfort get worse. The shoulder may become stiffer. Patients may feel a “catch” develop in their shoulder. Weakness and losing the ability to raise the arm may indicate a serious rotator cuff problem. Treatment Options What does it take to get your shoulder feeling better again? Conservative treatment is usually indicated first. The doctor may prescribe anti-inflammatory medications. Therapy sessions can prove very helpful especially if caught early. Typically, if it is very early on, we use ice if the shoulder is inflamed. If it has been going on 6 months or longer it’s probably more of a tissue degeneration problem and we use heat typically. We stretch particular muscles that are tight. We also use strengthening of the muscles that are weak. The overall affect is to restore balance of the shoulder joint so it operates smoothly. We also may use electrical stimulation to ease pain or strengthen muscles. Lastly, we try to teach patients how the joint works so they can avoid the impingement syndrome from reoccurring. If conservative treatment fails, the doctor may also try a cortisone injection or surgery to correct the problem. The goal of surgery is to create space in the shoulder joint and reduce the impingement. If the patients end up requiring surgery they will need to follow-up with therapy to help the healing process of the shoulder joint. We can create a program of stretching and strengthening of the shoulder muscles and tendons that suits. TIPS TO AVOID THE IMPINGEMENT SYNDROME In order to help keep the shoulder healthy and avoid impingement syndrome here are a few suggestions: Avoid excessive overhead work, if you are able. If you have to do overhead work try to take breaks or do work occasionally below shoulder level during your shift or work at home. Get a stepladder instead of reaching far overhead. If your shoulder gets sore after activities try ice first, if this fails try heat. In either case don’t overdo either ice or heat. Once or twice a day for 15 minutes will do. Stretching of the shoulder can help keep the tissues healthy. If you feel your shoulder is getting tight give us a call for a free screening/consultation. Take medicine only in moderation as your doctor recommends. Excessive amounts of anti inflammatories or Tylenol can cause serious problems with your stomach, liver, and kidneys. Rather than overdoing it with medicine see us for help or talk to your doctor about your problem. Therapy can often be very helpful. If you feel your patients have shoulder pain that is not going away give us a call. They will be able to do activities they have been missing for some time. Give us a call for an appointment. You will be glad you did. We can help your patient take control of their problem. |
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