Here at Elite Performance Therapy, shoulder pain is up there as one of the most common complaints we treat, after lower back and neck pain. Office workers, gym goers and overhead sports people, such as basketballers and netballers are all regular victims of shoulder pain.
A common shoulder complaint that we see is shoulder impingement, otherwise known as subacromial impingement. Say ‘shoulder’ and most people think of a ball and socket joint. This joint does indeed make up a large part of the shoulder, but there is much more to it than that. Over the top of the ball and socket joint sits a bony ‘bridge’ which is made up of the collar bone (aka the clavicle), shoulder blade (specifically the ‘acromion’ part of the shoulder blade) and a joint which connects the two (aptly named the ‘acromio-clavicular’ joint). Beneath the bridge and above the ball and socket joint is a small gap called the sub-acromial space (sub = underneath).
It is within this space that the abovementioned impingement occurs and if present, may cause pain when moving the arm.
Why does impingement occur?
There are a number of soft tissues which run through this space that help keep the shoulder functioning. These parts include the tendons of the biceps and one of the rotator cuff muscles, a ligament and a fluid-filled sac called a ‘bursa’. Bursi allow smooth, frictionless movement around joints and can be found all over the body. Any of these body parts can be involved in shoulder impingement if they become inflamed. Repeated, overhead arm use in throwing sports, or chronic poor positioning of the shoulder and posture in desk workers can lead to these soft tissues becoming irritated and inflamed. For example, a cricketer who spends a large part of their career throwing a ball could lead to increased stress placed on the rotator cuff tendon that passes through the space, leading to inflammation, wear and tear, and poor movement. This then has a direct effect on other surrounding structures, so a person may end up with an inflamed bursa too.
Signs and Symptoms
When someone has shoulder impingement, they may experience any or all of the following:
• Pain when moving the arm (e.g. our cricketer above may feel pain when throwing)
• Decreased range of motion in the shoulder
• Weakness when using the arm on the affected side
• Reduced ability to perform everyday tasks such as reaching up high in a cupboard, doing up a bra, putting on a coat or holding/lifting a child
How can we help?!
In order to address impingement, a dual treatment of chiropractic and soft tissue is the most effective, long term treatment. First of all treatment is aimed at restoring good pain free range of motion using mobilisation, manipulation of upper back and neck and soft tissue techniques. Part of your initial assessment will also include looking for muscular imbalances that are present which may be the cause for injury.
At Elite Performance Therapy we will also question you on your daily activities which may be a cause such as posture, repetitive activities in work or poor technique in sport such as that seen in swimmers swimming. We will then prescribe you exercises to address areas of imbalance and help restore good muscular balance to help prevent further re-injury.
With shoulder pain we would always recommend treatment in the early signs of shoulder pain as if left, altered movement patterns occur and have an affect globally with a chronic shoulder injury much more difficult to treat.
We pride ourselves on awesome treatment, but shoulders are often tricky to treat, and some cases may take longer than others. To ensure you get back on the right path as quick as possible, always follow our advice between treatments, and please do your exercises! If you have weakness somewhere which is leading to your pain, a few treatments are not going to resolve this. Weakness and instability need strengthening, and strength takes time to build. Consistency is key with exercise. We will educate you on what you need to do, but you need to be the one to do it at the end of the day.
It’s a team effort 🙂
We know it’s hard to keep motivated, but rest assured we will always be there on those days when you need a hand!
Should you wish to discuss your injury please do not hesitate to contact us on 0034 635 508 964 or send us a message here.
I met with Isy in early January 2021 as I’d been suffering with a long standing shoulder injury for over 18 months and wanted some new ideas and input as to how to improve it as well as hands on treatment. I’ve found Isy’s knowledge and approach to this excellent as well as her great work she introduced me to her colleague Sarah (Chiropractor) which complimented the work Isy had already done. Three months in and lots of attention from Isy and Sarah, the shoulder is considerably better than it was before. Thank you very much.