Injury blog: Shoulder impingement

Suffering from shoulder pain?

As osteopaths, shoulder pain is up there as one of the most common complaints we treat. Office workers, gym goers and overhead sports people such as basketballers and netballers are all regular victims of shoulder pain. Subcranial, or shoulder impingement is a common complaint we see. Say ‘shoulder’ and most people think of a ball and socket joint. This does indeed make up a large part of the shoulder, but there is much more to it than that. Above the ball and socket joint sits a bony ‘bridge’ which is made up of the collar bone. The shoulder blade (specifically the ‘acromion’ part of the shoulder blade). And finally a joint which connects the two (aptly named the ‘acromio-clavicular’ joint). Beneath the bridge and above the ball and socket joint is a small gap called the sub-acromial space (sub= underneath). It is within this space that impingement occurs and causes pain when moving the arm.

Why does impingement occur?

Well, there are quite a few soft tissues which run through this space that help keep the shoulder functioning. These parts include the tendons of the biceps and one of the rotator cuff muscles (a ligament and a fluid-filled sac called a ‘bursa’). Bursi allow smooth, frictionless movement around joints and can be found all over the body. Any of these body parts can be involved in shoulder impingement if they become inflamed. Repeated overhead arm use in throwing sports, or chronic poor positioning of the shoulder in desk workers can lead to these soft tissues becoming irritated and inflamed. For example, a cricketer who spends a large part of their career throwing a ball could experience increased stress placed on the rotator cuff tendon that passes through the space, leading to inflammation, wear and tear, and poor movement. This then has a direct effect on other surrounding structures, potentially causing an inflamed bursa too.

Signs and symptoms

When someone has shoulder impingement, they may experience any or all of the following:
– Pain when moving the arm
– Decreased range of motion in the shoulder
– Weakness when using the arm
– Reduced ability to perform everyday tasks such as reaching up high in a cupboard, doing up a bra, putting on a coat or holding/lifting a child

Get to the osteo!
If you want to get on top of your shoulder pain quickly, then we recommend a trip to see us here at Infinity. During a thorough assessment we will work out what lifestyle or movement factors are responsible for your pain. Using a combination of soft tissue massage, joint mobilising, and many other techniques, will help reduce your pain and get you moving. Those with shoulder problems often have issues related to neck or back movement, so don’t be surprised if we look further than the shoulder for answers to your problem. If you are a thrower, we may ask you to demonstrate a throw so we may see how you are moving (don’t worry, we won’t ask you to do this if you are in acute pain). Likewise, if you are a desk worker, we may ask to look at your desk set up and sitting posture. Getting you to take a photo of yourself at your desk is often helpful for us to see if you need to make postural changes. When it comes to lifestyle advice, whether it’s the hobbies you have or the way you sleep, we’ve got you covered!We pride ourselves on awesome treatment, but shoulders are often tricky to treat, and some cases may take longer than others. To ensure you get back on the right path as quickly as possible, always follow our advice between treatments, and please do your exercises! Weakness and instability (a possible cause of shoulder impingement) need strengthening, and strength takes time to build. Consistency is key with exercise. We will educate you on what you need to do, but you need to be the one to do it at the end of the day. It’s a team effort. We know it’s hard to keep motivated, but rest assured we will always be there on those days when you need a hand!

If you want to give pain the cold shoulder, book an appointment today at infinityosteo.com.au. Or give us a call on 9846 2800 and visit us at Donvale, Templestowe or Warrandyte.