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Shoulder Impingement Syndrome: Causes, symptoms, and treatment

Shoulder Impingement Syndrome, a common cause for shoulder pain.

Shoulder Impingement Syndrome, also known as Swimmer’s or Thrower’s shoulder, is a common over-use condition that occurs when the shoulder bursa or rotator cuff tendons become compressed within the shoulder joint. The shoulder joint is comprised of the scapula, humerus and clavicle. The tip of the scapula, called the acromion process, joins the clavicle to create the acromioclavicular joint. The narrow passage below this joint, the subacromial space, is where compression occurs.

Those who perform repetitive overhead movement (athletes, laborers) are at the highest risk of developing shoulder impingement. However, as technology and careers have evolved, it is becoming more common in those with poor posture and rounded shoulders. Overuse and poor positioning of the shoulder can cause tendon microtrauma and inflammation of the rotator cuff muscles. This may cause thickening of the tendon, decreasing the diameter of the already narrow subacromial space. At this point, movement of the shoulder may cause the tendon to be pinched underneath the acromion, causing pain and limit range of motion.

There are a wide range of treatment options for shoulder impingement syndrome, including adjustments, manual therapy and exercise. When you visit your practitioner, their goal should be to discover the underlying cause of impingement. Is it due to a recent trauma to the shoulder, too many pull-ups and presses, or repetitive use of a tool overhead? Once the cause is determined, therapy can be applied accordingly. The first step should be to manage the pain and reduce the strain on the area. Limiting the use of the shoulder, in combination with cryotherapy, will help relieve pain and inflammation. You may be asked to modify or take time away from your job or sport in order to achieve this.

The next step is to reduce muscle tension, correct structural misalignments, and improve range of motion. Chiropractic adjustments of the neck, thoracic spine and shoulder will be effective in achieving improved function and may be done in conjunction with another soft tissue therapies such as instrument assisted soft tissue mobilization (IASTM),  blood flow restriction therapy, or massage.

The final step in treating this issue is strengthening of the rotator cuff muscles and shoulder retractors and stretching the anterior shoulder and chest. By working to stretch and strengthen these muscles of the shoulder and back, proper posture and alignment can be restored and future damage may be prevented. Most of these strengthening exercises are performed with small dumbbells or resistance bands, making them very approachable and easy to do on your own. Your practitioner should provide you with a basic regimen to be done at home or at clinic visits.

In order to prevent this issue from occurring, you may implement the following strategies:

  • Maintaining a proper, upright posture with shoulders back when sitting or working
  • Using proper technique when lifting or performing exercises
  • Strengthening the rotator cuff and upper back muscles
  • Stretching the anterior shoulder and chest, neck and back muscles
  • Regular chiropractic visits

-Taylor Meyers, Intern Core Health Chiropractic

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