So You Have A Shoulder Impingement? What Does That Mean? How Does PT Help?
Quick Anatomy Lesson:
There are four muscles that assist the larger deltoid group to lift and lower the arm and are collectively known as the rotator cuff. The rotator cuff lies under the roof of the shoulder, the acromion, which is part of the shoulder blade. There is a space between the rotator cuff and the acromion which is filled by the subacromial bursa, a fluid filled sac that allows for smooth gliding of the rotator cuff under the acromion during shoulder movements.
The rotator cuff functions to depress and centralize the humeral head in the joint. When the arm is raised overhead, the rotator cuff depresses the humeral head allowing it to glide freely underneath the acromion. If there is any abnormality with the rotator cuff, the depressing and centralizing of the humeral head will be compromised. Consequently, during overhead movements the humeral head can glide upward and closer to the acromion causing possible impingement. The rotator cuff and the acromion will rub against one another, causing pain and possible inflammation, which is commonly known as impingement. Some pathologies of the rotator cuff include: tendinopathy due to chronic use, partial or full thickness tear, and calcific tendonitis. Some indirect causes are: glenohumeral instability, labral tears, abnormal movement patterns of the shoulder due mobility issues at the thoracic spine, scapula, and/or shoulder.
Physical therapy treatment:
Each shoulder impingement can present differently. A licensed physical therapist will perform a thorough personalized evaluation to determine a specific intervention based on your presentation.
The goal of physical therapy is to reduce pain, improve overall movement of the upper arm, and patient education in regards to preventing further injury. This is accomplished through:
• Therapeutic exercise intervention intending to improve movement patterns • Strengthening appropriate musculature of the rotator muscle group • Improving overall patient posture to ensure optimal overhead movement patterns • Manual therapy techniques to assist in pain reduction and restoring proper movement.
Improving the improper movement patterns, strengthening the rotator cuff muscle group, improving overall posture to ensure overhead movement patterns are optimal, and manual therapy techniques to assist in reducing pain and restoring proper movement.