Do you have shoulder pain that flares up when you do things you used to do without pain? Do you, or have you done a lot of swimming, or throwing in the past? Have you done a lot of over head things like painting? Do you sit at a desk working for many hours and then your shoulder bothers you? Many of us have played sports, or were more active when we were younger, but now we spend most of our time working. We still love to do the things we used to, but sometimes we pay the price.
You may be suffering from a shoulder condition known as subacromial impingement. Other common shoulder injuries include rotator cuff tendinitis and rotator cuff tears. The rotator cuff muscles stabilize the arm in the shoulder socket. They are important in any shoulder movement, especially throwing or overhead activity. With a rotator cuff injury, the arm feels heavy and it is difficult to lift it over head. Reaching behind your head may be painful and difficult. Less common causes of shoulder pain are caused by a labral tear. The labrum is strong tissue that helps stabilize the shoulder bones. It can tear in a fall, or with overuse. With a labral tear you could have some clicking or catching in your shoulder. Your shoulder might occasionally lock and you will have pain with shoulder movements. These are common examples of how some shoulder injuries manifest themselves. If you think you have any of these injuries you should see your doctor of physical therapy. They will diagnose what is causing your pain and help you get better. We will discuss the diagnosis of subacromial impingement and the signs and symptoms. We will then talk about why this particular condition is so painful and what physical therapy can do to help.
Signs and Symptoms
Do you have pain when you try and reach over your head? Do you have shoulder pain after weekend activities? Do you have pain with swimming? Or pitching? Do you work at a desk for hours each day? Individuals with subacromial impingement will have the following:
- Pain when reaching overhead, out to the side, and behind their back (pain when putting on or taking off a t-shirt, fastening your bra strap behind your back, threading a belt loop, or washing your hair)
- Shoulder soreness or achiness during and after shoulder activity
- Pain in the front or top of the shoulder, or occasional pain in the bicep
- Pain while sleeping on the affected side
- Feelings of weakness associated with pain when lifting
- Pain while working at a desk
If this sounds like you, it is advisable to have this treated before the injury causes more damage to your shoulder. There are many different shoulder injuries and all are treated slightly different. If you are having shoulder pain you should schedule an evaluation by a doctor of physical therapy.
What is causing the pain?
Subacromial impingement happens when your arm bone lifts up and pinches tissues between other bones in your shoulder. These tissues that are being pinched include the rotator cuff muscles and a bursa. A bursa is a gel like pad of tissue that sits between the bone and the muscle to reduce the friction between the two when the arm moves. With subacromial impingement these structures are pinch repeatedly and become irritated, inflamed and painful. If ignored for long enough they can become damaged. Individuals slowly become more susceptible to this injury as their shoulder stabilizing muscles begin to weaken and as their posture worsens. So, when a person with weak stabilizing muscles and poor posture spends an afternoon doing overhead movements like throwing a football (movements that pinch the rotator cuff muscles, as described above) the stage is set for injury. The injury typically happens through excessive use of the shoulder, like swimming, or throwing a baseball or football (overuse). Subacromial impingement can also happen to people who assume poor posture while working at a desk for long periods of time. Their poor posture places a constant pinch on the tissues in the shoulder. This is condition is treatable. Seeing a physical therapist will get you back to enjoying your hobbies without pain. Physical therapists are experts on body mechanics and they will be able to provide you with the specific information you need to correct your particular pain.
When you visit your doctor of physical therapy, they will ask you some questions about how and when the pain started, what it feels like, and when it bothers you. Then they will perform an extensive physical examination. The physical therapist will determine exactly which muscles are tight, which ones are weak, and what postural corrections need to be made in order to take care of your pain. They will determine what exactly your injury is and how best to go about treating it.
This injury may seem a minor irritation but when you address it appropriately, it is treatable. If left untreated, it can develop into more serious injuries that are more painful and more debilitating. Untreated subacromial impingement can lead to bursitis, inflammation of the bursa, as well as tearing the rotator cuff muscles. Treating these conditions becomes much more complicated. The sooner you visit your physical therapist, the sooner you will be on your road to recovery.
Physical Therapy will work to heal the injured tissues, and relieve your pain. They will utilize modalities like moist heat, ultrasound and possibly iontophoresis to relieve the inflammation in the shoulder. Iontophoresis uses electrical charges to deliver medications in very specific locations. The modalities will decrease the tissue inflammation and accelerate the healing process. The physical therapist will stretch the tight shoulder capsule to allow for increased movement. They will prescribe exercises that strengthen the muscles providing shoulder stability, and teach you how to perform your activities with pain free motions. They will correct your posture. This condition is very treatable and your physical therapist will give you tips on how to manage your activities and posture to prevent future reoccurrence. They will work with you to get you back to swimming, throwing and doing the activities you want to, just without the aches and pains.
Call today to schedule your appointment at Total Performance Physical Therapy!