Shoulder pain is one of the most common orthopedic injuries seen by physical therapists. While there are dozens of possible sources regarding the cause of shoulder pain, many symptoms can be traced to shoulder impingement syndrome. Shoulder impingement is decreased space for the rotator cuff muscles to pass underneath the top of the shoulder bone. This decrease in space literally causes an impingement or pinching of the structures.
The resting position of the shoulder joint can be compared to a golf ball resting on a golf tee. It seems as if the golf ball should fall off the tee with the slightest malposition. Fortunately the shoulder has many stabilizing structures surrounding the joint which create stability in different ranges of motion. These stabilizers are both static and dynamic. Normal shoulder movement requires a combination of both forces to work together. The bones need to be in good alignment to allow the muscles and ligaments to work in harmony. Using the analogy above, these forces keep the golf ball in the center of the tee. When the tee becomes off-centered, shoulder impingement, dislocations, and/or rotator cuff tears occur.
As a physical therapist, I address shoulder impingement using a cominbation of manipulative therapy, retraining movement patterns, and corrective exercises. Since individuals often have poor posture, I address their postural deficits first. This includes restoring normal movement in the middle back and neck as well as educating the patient on their posture throughout the day. Generally, people notice decreased pain within a few days and have significantly improved in 4-6 weeks.
Corrective Exercises for Shoulder Impingement
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