Shoulder Impingement Pain

Shoulder impingement is a problem involving the rotator cuff muscles of the shoulder. This problem generally affects people in sports or activities that require overhead movement.

Anatomy  

The shoulder in the human body is made of three bones, the humerus, scapula and clavicle. The humerus is the upper arm bone, scapula is the shoulder blade and the clavicle is the collarbone. The shoulder joint is a ball and socket type of joint, as the head (ball) of the humerus joins the glenoid fossa (socket) of the scapula. The rotator cuff muscles are responsible for stabilizing the humerus and simultaneously controls the movement of the joint.  A bursa, a lubricating fluid sac, sits between the rotator cuff tendons and acromion of the scapula and helps in allowing the tendons of rotator cuff move freely during movement of the arm. These tendons pass below a bony area (acromion) before attaching to the arm bone. When the tendons and bursa are injured or inflamed due to repetitive movement of the shoulder they may become “pinched” and cause pain or discomfort.  This is known as shoulder impingement. 

Cause

The causes of shoulder impingement typically come from sports that require overhead arm movements such as swimming, tennis, baseball and of course rock climbing.  However, shoulder impingement can also develop from daily activities that require overhead positioning of the arms such as construction work, stocking shelves, and sleeping on your side.  Rotator cuff tears, tendonitis, bursitis and bone spurs can aggravate the condition.    

Symptoms

The symptoms of shoulder impingement are weakness, pain radiating to top part of the arm, stiffness, pain on movement of the arm (especially overhead) and loss of shoulder mobility.  Sometimes, a popping sensation and grinding may also be felt with shoulder movement.

Diagnosis

Shoulder impingement is usually diagnosed through a physical examination but an X-ray or MRI can help visualize bone spurs, tears, swelling or inflammation of the rotator cuff. 

Treatment

Chiropractic treatment of the shoulder can help reduce pain and improve your mobility without resorting to medications, injections or surgery.  Chiropractic manipulation treatment involves mobilizing the scapula, thoracic spine and the acromioclavicular joint to allow better range of motion for the shoulder.  Massage techniques such as Graston Technique and Active Release Technique are used with chiropractic manipulation to prevent tight and overactive muscles from pulling joints out of proper alignment. 

Other common treatments include rest, stopping activities that aggravate the problem, Ice packs and anti-inflammatory medications, physical therapy, Cortisone or corticosteroid injections, and in some cases, surgery to remove bone spurs or to repair torn rotator cuff tendons.