Shoulder impingement is a broad term for anterior(front side) shoulder pain usually worse with overhead activities. There’s a few specific kinds of of impingement (subacromial, subcoracoid and posterior impingement) but the most common is the subacromial type. Some practitioners are getting away from using this term because it doesn’t really tell us which structure is injured. I still use it, but then try to identify the specific area involved. Sometimes we utilize diagnostic ultrasound to look at the rotator cuff, the bursa and some of the other surrounding structures including the biceps tendon. We also look at the intrinsic risk factors for shoulder impingement which include stiffness in the upper thoracic spine, muscle imbalances around the shoulder girdle. Some sports actually require an entire kinetic chain assessment as in baseball players and golfers. We try to be specific for the individual’s impairment and goals.
Shoulder impingement treatments
- Specific stability exercises for the shoulder and scapula.
- Manual therapy including soft tissue mobilization to the shoulder, thoracic spine and cervical spine.
- Laser therapy to speed recovery and decrease pain.
- Mobility exercises for the spine and shoulder.
- Taping techniques for posture or shoulder positioning