Physiotherapist Advice for a Shoulder Impingement
“My shoulder has been aching for months…”
And what did I do? … One of the most common problems a physiotherapist faces is long-standing shoulder pain caused by shoulder impingement. It typically appears in the shoulder as a mild ache that worsens over time, and can become painful enough to start affecting function. This form of condition may follow a prior acute shoulder injury in many cases. However for no apparent reason for the pain, it is also normal. Pain is usually felt when raising the arm in an arc; in other words, at a certain point, feeling the pain and then finding that after that point has passed, it decreases. The region of pain can also be felt down the arm, which can lead individuals to believe that the issue, not the shoulder, is their upper arm. original site
But what exactly does my diagnosis mean? Structures within the space of the shoulders are compressed together when raising the arm. Impingement of the shoulder refers to components such as tendons being compressed. There may be two explanations why this is happening. Bad biomechanical activity around the shoulder is more common. The shoulder’s blade (scapula) and the arm must work in unison to allow movement without pain in order for the shoulder to work properly. The scapula does not move in the correct pattern when the muscles around the scapula do not do their job properly, resulting in impingement and thus pain. The room can also be structurally reduced in size. This can occur because over time, the flat protruding portion of the scapula at the top of the shoulder can degenerate, leading to bone protrusions into space. This small space results in impingement, which can involve rectification by surgery.
What am I supposed to do? Step 1: ACUTE MANAGEMENT (0 DAYS – 1-2 WEEKS) Stop pain-aggravating shoulder movements – failure to do so will only prolong the inflammation. Use ice: Use ice for 15-20 minutes, 2-3 times a day when the pain is extreme and inflammation is resolved. As soon as possible, start treatment. Treatment with physiotherapy will normally begin by focusing on the tight muscles and structures in the region, using a simple corrective exercise programme at the same time.
Next what? Step 2: SUB-ACUTE MANAGEMENT (1-3 WEEKS) The pain should be significantly decreased at this stage. The exercise programme would aim to use the ground work accomplished through the fundamental exercises. The programme will continue to concentrate on the restoration of the shoulder’s proper biomechanical function. As required, manual therapy may be used, but less emphasis should be placed on it. Step 3: RETURN TO NORMAL FUNCTION (3-10 WEEKS) Pain should largely resolve as the normal biomechanics of the shoulder return. The primary focus of therapy will be the exercise programme, and treatment frequency will also decrease. Exercises can increase the challenge of ensuring that the strength of the muscles of the scapula can withstand everyday exercise and if necessary, sporting activities. Physiotherapy may no longer be needed, and the responsibility of completing the assigned programme may be turned over to the patient. It is possible to continue the exercise for a few months after the completion of treatment, thus eliminating any risk of the disorder returning.
The ultimate word… As each of us is different, you can advance towards someone else at a different rate. Owing to your particular interests, your recovery programme can vary from others. Each stage has some objectives that your physiotherapist can help you accomplish before the next stage starts. You and your physiotherapist will establish the best outcome for your particular injury as a team. If you have any concerns about your recovery programme, just discuss them on your next appointment with your physiotherapist treating you.