Shoulder impingement physio diagnosis and treatment
Catering to the swimmers of the eastern suburbs and the ball-sports of Queens and Centennial Park, Movement Centre in Randwick sees its fair share of shoulder impingement physio problems and rotator cuff physio problem.
Shoulder impingement is not a diagnosis in it’s own right. Rather it is a condition in the shoulder involving an irritation of soft-tissues between two bones of the shoulder. The impingement of these tissues can lead to rotator cuff tendon problems such as tears and tendinopathy, and inflammation of the bursa, known as bursitis. This irritation often occurs from repetitive overhead activity like swimming, throwing and weight lifting.
These activities aren’t themselves problematic; but often an increase or change in our exercise load is involved in the onset. Some of the common contributors we see include increasing swimming distance, or changing from pool (flat) to ocean (choppy water) swimming. Also the commencement of summer cricket and tennis season often leads to a spike in Randwick physio shoulder impingement cases.
Shoulder Impingement – What’s happening in there?
When we move our arm above shoulder height, the head of the humerus (the ball) has to rotate relative to the glenoid (socket). Without going into too much detail, this process involves a complex interplay of different muscles, tendons and ligaments. With repetitive overhead use like throwing, swimming or weight-training, we can develop tightness in parts of the rotator cuff, and weakness in other parts. This can mean that in movements of the arm above shoulder height, we can experience an impingement/ compression of the tendons and bursa. Over time this can lead to changes in the tendon leaving it sore, weak or more prone to tears, and acute or chronic bursal inflammation.
So, is it shoulder impingement? Or swimmer’s shoulder?
One of the tell-tale signs we see in our shoulder impingement physio patients is a painful arc of movement in the shoulder as it moves above 90 degrees. The pain is generally in the top, lateral part of the shoulder. Our physios at Movement Centre in Randwick can diagnose shoulder impingement and potential cuff or bursa involvement, and get you on the path to recovery.
What does it mean for your exercise?
Everycase is different, and you will need to discuss your management and return to sport with your physio. Often we need to have some relative rest of overhead activity. This doesn’t mean complete rest, and our shoulder impingement physio approach is to always find activity that you can do.
Decreasing the time and repetitions of overhead activity is often necessary – at least in the short term. This may mean a 30minute surf rather than a 2hour surf; or bowling 5 overs, not 10 overs in cricket. Our physios may do some specific soft-tissue massage and mobilisation to help encourage movement of the shoulder.
What shoulder exercises should you do?
Our physios will give you detailed exercises to supplement your activity modification. This will often involve rowing movements to strengthen the scapular stabilisers. Specific rotator cuff exercise may help improve the strength of the cuff and help to avoid ongoing impingement movements. Speak to our team at Movement Centre to get a tailored shoulder impingement physio or rotator cuff physio program. We have a fully equipped rehab gym space for our patients to go through their exercises outside of their appointment times.
