Shoulder Impingement Syndrome
Do you have shoulder pain? Does it get worse when you lift your arm out to the side or when you twist your arm? Has it been making it difficult to carry different items or perform different tasks at work? You might have what’s called shoulder impingement syndrome!
What is It?
As we get older, it is common to notice movement problems and pain with our shoulders. However, if left untreated, most shoulder conditions tend to get worse. What occurs in shoulder impingement is the space between the bones and muscles becomes more narrow. This narrowing of space wears on one of the tendons of the rotator cuff and can lead to a tear and possibly surgery. But if treated early enough, those problems can be avoided.
How Does Shoulder Impingement Occur?
Historically, this condition was caused by overuse activities with different sport and job demands like swimming, throwing, construction/carpentry and plumbing. Now, this condition is commonplace for people with poor posture that spend prolonged periods of time on the computer and phone. There are also muscular imbalances in the shoulder that are common and can create the impingement.
How is It Diagnosed?
Oftentimes from the history and presentation, this condition is suspected and confirmed with the physical examination. This includes taking the shoulder through all its ranges of motion and observing how the motions feel and find which ones are limited and/or pain provoking. The physical examination also includes orthopedic tests that are meant to stress different tissues of the shoulder to find out which tissues are at fault for causing the pain. Often, patients will exhibit what is called a painful arc, which is pain caused by raising the arm out to the side and is painful in the 80-120 degree range. Patients will also complain about pain with twisting their arm down or toward their stomach (internal rotation). Both movements close the space the supraspinatus tendon travels through. Two common confirming orthopedic tests include Neer’s and Hawkins-Kennedy that again close the space in different ways and provoke the patients familiar pain symptoms.
How is It Treated?
At Moyer Total Wellness, we use a research based, 4-Step Approach to the conservative treatment of shoulder impingement that involves:
- Remove knots from muscles
- Lengthen tight tissues
- Mobilize joints
- Strengthen weak muscles
Whether you see a massage therapist, acupuncturist or chiropractor, we all use the same approach to care. However, we recommend starting with a chiropractor first, in order to get the right diagnosis and treatment plan. Treatment with Dr. Dange Wolf, DC would involve finding which muscles are too tight and overactive and which ones are underactive and lengthened. Specific exercises are given to strengthen certain muscles so that there is even pull on the shoulder. Chiropractic adjustments may also be delivered to the shoulder joint to improve proper range of motion. Along with evaluating and treating the shoulder, the neck and upper back often have movement restrictions causing faulty movement patterns of the shoulder. Treating these areas has a positive effect on the movement range of the shoulder.
How Long Does It Take to Heal?
In cases where the condition is due to functional issues like muscular imbalances or overuse activities, 60-90% of shoulders will heal in two to six weeks. There are many factors that play into the range of healing time and include adherence to treatment plans, stage of the condition, home exercises, and the demands placed on the shoulder either from sport or work-related stresses. Other treatments that may help speed the recovery process while under chiropractic care include physical therapy and acupuncture. In cases where the problem is from a structural abnormality of the acromion process, an orthopedic consultation will be advisable.
Dange Wolf, DC
Author, Doctor of Chiropractic
Dr. Dange Wolf, DC was born and raised in Portland, Oregon and completed his undergraduate studies in Exercise Science at Western Oregon University where he was an All-American Midfielder on the lacrosse team. After completing his undergraduate studies, he went on to attend the Chiropractic program at the University of Western States in Northeast Portland, where he graduated summa cum laude. In early March of 2021 he moved to Lakewood, Colorado and has been treating a wide variety of musculoskeletal complaints ever since.
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Steuri, R., Sattelmayer, M., Elsig, S., Kolly, C., Tal, A., Taeymans, J., & Hilfiker, R. (2017). Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs. British Journal of Sports Medicine, 51, 1340-1347. doi:10.1136/bjsports-2016-096515
Vizniak, N. (2015). Quick Reference Evidence Informed Extremity Manual. Professional Health.
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