What is shoulder impingement?
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A shoulder impingement is a general term for the pinching or squashing of the soft tissue structures that lie under the coracoacromial arch - the tunnel formed by the acromion process at the top of the shoulder and the coracoid process that juts forward from the scapula. Housed in the arch are a large bursa, the tendon for the supraspinatus muscle and a bundle of nerves and vascular structures. Normally, there isn't a lot of free space for movement, but when there is inflammation of any of these structures or the position of the shoulder changes in the long term, there is even less room to move and this can cause irritation and pain. Pain will often strike in overhead activities, as well as lying on that shoulder at night, and can radiate across the shoulder and into the upper arm.
How we treat it
Many people struggle with shoulder impingements, despite rest from activity and avoid overhead movements in the long term. We find that modification of the regional shoulder mechanics is the fastest way to ensure complete recovery - some hands on treatment does help, but changing the way the shoulder moves significantly relieves the pressure off the area and gives the structures in the arch the space they need to heal themselves. Without this change, the arch remains compressed and irritable and for this reason our treatment focuses on changing the overall posture and quality of movement using therapeutic exercise after the initial hands-on treatment.
Unlike physiotherapy, we have the luxury of long appointments at Pain Free Fitness: up to a full hour with your therapist or coach. With more time, we can get much faster results in terms of pain reduction and prevention of recurrence.
Unlike physiotherapy, we have the luxury of long appointments at Pain Free Fitness: up to a full hour with your therapist or coach. With more time, we can get much faster results in terms of pain reduction and prevention of recurrence.
Assessing the scapulohumeral rhythm of the shoulder girdle.
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getting you back into pain-free activity
Many of our clients express concern about getting back into the gym, sport or activity after stopping because of pain. They have been on the 'merry-go-round' where pain stops when they stop, but returns when they start again. This is where we can bridge the gap between traditional therapy and return to exercise.
The final part of our treatment will include a full movement assessment, taking into account your usual activities or sport. This enables us to establish your 'weakest links' (and likely cause of the issue) while actually performing your activity - not just while on the massage table. For example:
By going through this process, we can fully address the cause of your original pain, and prescribe you a specific program where the exercises constitute the final piece of the therapy puzzle. We use this as an education opportunity, and just about every client we work with has several lightbulb moments during these sessions as to why they move the way they do.
Our goal is for you to be able to self-manage your pain (rather than requiring ongoing therapy) and to re-program the way you move so you don't ever have to put up with this problem again. You will be stronger and have an improved overall foundation to build more strength and better performance.
If this process sounds like something you need, please click the button below to book a massage or myotherapy session.
The final part of our treatment will include a full movement assessment, taking into account your usual activities or sport. This enables us to establish your 'weakest links' (and likely cause of the issue) while actually performing your activity - not just while on the massage table. For example:
- Do your shoulder mechanics enable full rotation of the scapula while under load, or do you overuse your lats, traps and biceps to do any row or overhead movement? Is this natural patterning having an impact on your shoulder pain?
- Does your core strength support the movements of your upper body, or is your shoulder positioning causing a problem because of the relationship to the pelvis or rib cage?
- Advice on how to modify training loads (not stopping completely) is extremely important to maintain strength and support healing, recovery and confidence building.
By going through this process, we can fully address the cause of your original pain, and prescribe you a specific program where the exercises constitute the final piece of the therapy puzzle. We use this as an education opportunity, and just about every client we work with has several lightbulb moments during these sessions as to why they move the way they do.
Our goal is for you to be able to self-manage your pain (rather than requiring ongoing therapy) and to re-program the way you move so you don't ever have to put up with this problem again. You will be stronger and have an improved overall foundation to build more strength and better performance.
If this process sounds like something you need, please click the button below to book a massage or myotherapy session.