Over the last few months I have been attending a few gyms around the Pyrmont area which include the Ian Thorpe Centre and University of Sydney of Technology to conduct some screening sessions for a number of members associated with the gyms. There has been a variety of conditions I have come across but one in particular has been prominent. Shoulder Impingement has been undoubtedly the most common complaint. I have recognised this condition is poorly understood and commonly mistreated. So far, I found that clients tend to try treat themselves by using Dr Google or following poor advice from non-professionals. So lets look a little closer to what shoulder impingement means and how important it is to seek professional advice and management.
Shoulder Impingement is a common condition that is caused when the rotator cuffs are pinched as they pass through the subacromial space formed between the Coraco-Acromial arch, AC joint, Acromion and the Glenohumeral joint. This impingement can cause swelling and damage to the muscle and tendons. Shoulder Impingement can be:
Primary External Impingement:
- Abnormal surrounding bony structures –> A curved or hooked acromion
- These abnormalities can be congenital or a build up of bony growth (osteophytes)
- Thickening of the Coraco-Acromial arch
- Bony formation of the AC joint
Secondary External Impingement
- Inadequate scapula stabilisation –> the rotating scapula pinches down on the subacromial space –> this is a results of weaker or tighter stabilizing muscles creating an imbalance
- This commonly occurs in the late stage of throwing whereby the rotator cuff tendons are impinged between the humeral head and the glenoid (scapula).
Treatment options & How to Treat Shoulder Impingement
Treatment is completely dependent on the type of impingement that has caused your pathology and will always begin with a conservative approach including:
- An accurate diagnosis of the cause of impingement which will be given to you by your Physiotherapist
- Soft tissue techniques
- Dry needling
- Rotator cuff and periscapular strengthening
- Self-reliant strategies using rollers, trigger point balls
Generally speaking a successful conservative treatment should take between 3-6 weeks.
Non conservative approach –> only explored with an unsuccessful conservative approach
- Cortisone Injection
- Surgical intervention –> looking at repairing any torn tissue or address any primary external impingement structures
It is important to understand that both these interventions will require between 4-6 months of Physiotherapy rehabilitation and are by no means a quick fix.
Useful products for optimal self Management sold at at bounceREHAB:
TENS portable devices $200
Anti-Flamme topical cream $25 & $ $45 (90 & 450 grams)
Heat packs $35
Cold Compression Cryo Cuff Hire $30 per week (plus deposit)
Pilates Home Kits (exercise tubing) $30 or Theraband $10/meter
Shoulder Door Pulleys $20
Foam Rollers – small $35 large $55
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PHYSIOTHERAPIST M.Physiotherapy, PG Cert. Human Movement Sc, B. Coaching Sc