Are you feeling the pinch?

Following on from our previous article on frozen shoulder, we discuss another common complaint, shoulder impingement.

What is shoulder impingement?

The shoulder is stabilised by a group of muscles called the rotator cuff. A shoulder impingement is when the tendons of these muscles get trapped as they pass through a bony space.

Repetitive pinching of these tendons can lead to injury, creating inflammation, swelling and pain. The swelling can increase the pinching, creating a viscous cycle especially if the issue is not addressed, with the right treatment, at an early stage.

The symptoms

The classic symptom is a sharp, catching pain that normally stops you in your tracks, most commonly felt when you move your arm out to the side and above your head.

For many the initiation of the movement is pain free, then the shoulder catches suddenly and then eases as you continue to move your arm upwards. This is what is called a painful arc.

Normally patients complain of pain particularly when trying to take a piece of clothing off over their head, putting their hand behind their back or head or attempting to reach or lift. The pain is usually in the top of the shoulder and arm but may extend as far as the elbow. Sleep is often disturbed, especially when lying on the affected shoulder.

The causes

There are many causes and often it’s a combination of issues that leads to this condition. Here are a few causes:

• repetitive overhead movement of the arm, causing the tendon to be pinched. This can happen in some sports, home chores such as decorating, cutting a high hedge etc
• trauma to the shoulder, eg. a fall
• an underlying condition such as osteoarthritis to the joint which can lead to narrowing of the bony space where the tendon can be pinched
• poor posture

Osteopathy for shoulder impingement

There are several stages in the treatment of this condition. After reaching a diagnosis, it is important to analyse what has caused the impingement as this dictates the treatment plan. In general the stages are as follows:

• reduce pain and inflammation
• restore full range of movement
• strengthen and stabilise the shoulder joint

If professional help is sought early, a shoulder impingement will usually respond quickly to treatment. However, it can become a viscous cycle if left and can then be slow to improve, sometimes requiring other intervention such as a steroid injection.

So if you have symptoms similar to this, our team of Osteopaths would be more than happy to help resolve it but would encourage you to do it early!