BY PAUL DARDAGAN
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
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
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:
Microcurrent/TENS portable devices $60
Anti-Flamme topical cream $25 & $ $45 (90 & 450 grams)
Heat packs $35
Pilates Home Kits (exercise tubing) $30 or Theraband $10/meter
Shoulder Door Pulleys $20
Foam Rollers – small $35 large $65
Postural support/harness $56.50
Trigger point balls $16.50