One of the most common reasons that we see clients for shoulder pain and restriction is a syndrome known as shoulder impingement.
Symptoms of shoulder impingement include:
- Pain at the front and/or outside of the shoulder
- Clicking in the shoulder when raising the arm
- Pain when reaching behind the back (i.e. putting on seat belt or reaching into back pocket)
- Reduced range of movement of the shoulder (particularly with overhead movements)
- Weakness around the shoulder joint.
The shoulder is made up of 4 joints:
1. The glenohumeral joint: A ball and socket type joint where the humerus (upper arm bone) meets the glenoid cavity (socket shape) of the scapula (shoulder blade)
2. The acromioclavicular (AC) joint: Where the clavicle (collar bone) meets the acromion of the scapula
3. The sternoclavicular (SC) joint: Where the clavicle meets the sternum (chest bone)
4. The scapulothoracic joint: Where the scapula meets the ribs at the back of the chest.
There are many muscles which surround the shoulder and they function to give stability and mobility to the joint. An important group of muscles known as the ‘rotator cuff’ consists of:
- Supraspinatus
- Infraspinatus
- Teres minor
- Subscapularis
The tendons of the rotator cuff (particularly the supraspinatus tendon) pass through the narrow bony space beneath the acromion in the subacromial space and can sometimes be pinched in this area. This pinching can cause swelling, pain and clicking in the joint. If the pinching continues (such as with repetitive throwing or overhead movements) it can eventually lead to a tear in the tendon. This is known as a rotator cuff tear.
People at risk of shoulder impingement include young athletes participating in activities requiring repetitive shoulder movements e.g. swimmers, baseball pitchers, tennis players. Also, older people who have developed bony spurs or altered postures causing reduced space for the rotator cuff tendons to pass through the subacromial space. It is important to note that often older people will have rotator cuff tear present and have no symptoms at all.
Treatment of shoulder impingement can include:
- Rest from the aggravating activity
- Stretching of tight muscles
- Strengthening of the rotator cuff and surrounding shoulder muscles
- Biomechanical changes to aggravating activity (i.e. tennis serve)
- Ice to inflamed areas
- Taping to assist with muscle and postural control.
If you are suffering from pain in the shoulder be sure to book in and see one of our friendly physio’s. The shoulder is one of the most mobile joints in the body and as a result it can be difficult to assess and treat. Getting advice from a physio is one of the most important steps you can take on the path to recovery!
For more information or to book a consultation, please visit our website www.fitwise.com.auor call our rooms on 9822 4999 (Armadale) or 9486 0512 (East Melbourne).
