What is shoulder impingement?

Shoulder impingement is really a generic term. Used to describe pain through an arc of movement when lifting your arm. There are lots of theories on the causes of pain from the impinging of structures (hence the name) to a referral of pain from elsewhere, such as the neck. For decades it has been believed that the tendons or the surrounding soft tissues (bursa) are being pinched by bony structures. Leading to a program of management focusing on treating these structural problems. Therapist would try and work on posture in the belief that the shoulder position is wrong. Therefore increasing the chance of impingement. Exercises would also focus on strengthening of the shoulder muscles. If this approach fails inevitably patients are likely to end up on the operating table.  Interestingly however the long term outcomes of both physiotherapy and surgery are similar for non traumatic impingement pain.

Here is the problem

So why can therapy and surgery both be ineffective? It appears the focus on a structural problem is the main issue. It is well known that MRI investigation can find lots of structural problems (or shoulder pathologies) in pain free populations. So it appears the structure is not what is causing the pain.  So what is? This is a complex issue but can only be understood by listening to each patients individual story. It is essentially multi-factorial. In other words there are a number of elements that may contribute to ongoing pain. From the physical and lifestyles of a patient to the personal beliefs and fear behaviours. Tissues in the body can also become sensitive and de-condition. Therefore the pain a patient is experiencing is not usually due to damage or harm.

Can I get my shoulder better?

If you are experiencing pain with your shoulder, fear not, as there is a way out. As a physiotherapist it is my job to work out the pieces of your story. Help guide you along the road to recovery. Increase your confidence in moving again.  

If you have any questions contact the clinic directly or book an assessment.