Article by: Elinos Petrou

Shoulder impingement is a very common condition that many people suffer all over the world. It is when an individual feels pain, stiffness, or discomfort in the shoulder area. If not treated and ignored, it can lower the quality of life and lead to further pain in the body.

There are many treatments for shoulder impingement, but the best way to treat shoulder impingement is with conservative treatment like physiotherapy and medication if doctor refer.

Shoulder impingement is common among people who carry out sports activities such as swimming and tennis or have intense workouts in the gym, as well as construction workers, factory workers, miners, or any other occupation which requires people to lift heavy objects. If the shoulder is not treated, it can worsen the condition and lead to more severe problems. The most affected areas of shoulder impingement include:

  • The ligaments.
  • The bursa (which is a fluid-filled sack).
  • The area between the joints.

The most commonly affected areas of the body are the rotator cuff tendons and the LHBT (long head of the biceps tendon).

Understanding Shoulder Impingement

To deeply understand what shoulder impingement actually is, one needs to know that the shoulder is made up of three bones:

  • The scapula (shoulder blade)
  • The upper arm bone (also known as the humerus)
  • The collarbone (clavicle)

The acromion is the bone attached to the shoulder blade and the clavicle. These bones are joined with tendons, ligaments, and muscles, also known as the rotator cuff. The rotator cuff muscle and tendons can slide under the acromion when lifting something heavy. If the space between the tendons, bursa, and acromion is reduced, the compression builds up and causes impingement.

Usually, the person feels pain and stiffness in the area. However, over time, it can lead to irritation and swelling. As a result, one can also experience restriction when trying to raise their arms above their head or reach something heavy. 

Results Of Physiotherapy in Impingement Syndrome

The length of physiotherapy treatment for shoulder impingement can vary from person to person, depending on the severity of the condition and how the patient responds. For some, improvement will be noticeable within weeks, while others may find recovery takes a few months. It’s important that patients follow the physiotherapist’s guidance and continue with the prescribed exercises.

People can experience shoulder pain while sleeping, pain in the upper arm and shoulder area, and swelling. Physiotherapy can help reduce the symptoms and improve the condition by strengthening the muscles and improving the body movement.

Physiotherapy for Treating Shoulder Impingement

1. Pain Relief and Reducing Inflammation

One of the first ways physiotherapy helps with shoulder impingement is through pain management. This reduces the need for medication. As part of this technique, physiotherapists will use various therapies such as ice therapy, electrical stimulation, ultrasound, or heat therapy to reduce the pain and heal the body. They will also introduce gentle exercises to help the body maintain movement without worsening the condition. This can help reduce inflammation and allow movement of the neck. The techniques used will normally be cervical mobilization, which will allow the neck to move freely without discomfort, and manipulation, which will target adjustments, allowing tension release and improving the neck’s alignment.

2. Improving Body Movement

Shoulder impingement often leads to stiffness in the shoulder area and can limit a person’s ability to carry out daily activities. Physiotherapists will educate the patient about improving their quality of life. This can include providing them with stretching and mobility exercises to increase flexibility around the shoulder area and the muscles.

3. Strengthening the Rotator Cuff and Shoulder Muscles

With shoulder impingement, the patient will feel stiffness and weakness in the body. That’s why the main aim of therapy is to strengthen the muscles and reduce the compression of the tendons. With a physiotherapist consultation, you will receive a targeted exercise program that will mainly focus on strengthening the rotator cuff and the scapular muscles (shoulder blade muscles). With physiotherapy, muscle imbalances caused by shoulder impingement will be reduced and aid with functional restoration.

4. Providing Exercises

As part of physiotherapy, exercises will treat shoulder impingement. These pain management strategies will improve posture and external and internal rotations using bands and weights to improve body movement and flexibility. Lastly, mobility improvement will strengthen the shoulder area. These exercises will mainly focus on the rotator cuff.

5. Improving Posture

As the shoulder impingement condition progresses, the posture may become affected. Physiotherapy will help improve posture and help with back pain treatment because poor posture will further worsen the condition, as misalignment can cause further compression of the rotator cuff tendons. As part of physiotherapy, this will include postural correction exercises to help align the spine and shoulders.

6. Manual Therapy

This is the most common hands-on technique a physiotherapist uses. Manual therapy, like therapeutic massages, aim to soften the tissues through massage and release tension in the shoulder area. Consistent manual therapy will help with pain relief.

Final Verdict of Impingement Syndrome

Although shoulder impingement is a very common condition, it is painful and frustrating. However, physiotherapy is one of the most effective, noninvasive approaches that address the root cause by providing the correct treatment, reducing pain, and improving body function. The best physiotherapist can guide you on how to regain strength and mobility for shoulder movement.

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