Nearly one third of physician visits for complaints of shoulder pain are thought to be due to rotator cuff problems. The shoulder is made up of a ball (head of humerus bone) and socket (shoulder blade) joint. When the rotator cuff muscles are weak and other muscular imbalances occur around the shoulder joint, a person becomes more prone to injury. Shoulder impingement occurs when the rotator cuff muscles become pinched between the bones of the shoulder as the arm is raised up overhead. 

CAUSES

Shoulder impingement is common in two major groups of individuals: young athletes involved in throwing, serving or swimming, and middle-aged people under the age of 60 with occupations involving frequent lifting or overhead use of the arm, such as construction workers, assembly line workers and house cleaners.

SIGNS AND SYMPTOMS

Symptoms of shoulder impingement may include pain and stiffness in the shoulder while raising your arm, difficulty reaching behind your back and weakness in the shoulder muscles.

Left untreated, shoulder impingement may lead to a rotator cuff tear. The following are other conditions that may also be associated with
impingement syndrome:
• Bursitis - The bursa (fluid-filled sac) that cushions the rotator cuff becomes inflamed and fills with more fluid.
• Bone Spurs - Bony overgrowths or a “hooked acromion” can cause even more compression on the rotator cuff tendons which can lead to a tear.

TREATMENT

According to a study from the Journal of Bone and Joint Surgery, the goals of non-operative treatment of shoulder impingement syndrome are to decrease inflammation and restore healing of the
compromised rotator cuff musculature. Anti -inflammatory drugs and physical therapy are the primary means of conservative treatment for impingement syndrome.

HOW PHYSICAL THERAPY CAN HELP

Physical therapists will be able to identify any muscular imbalances and will be able to develop a comprehensive rotator cuff-strengthening
program tailored to each patient’s individual needs. Initially, the physical therapy rehabilitation program will include gentle range-of motion exercises, stretches and joint mobilization techniques to restore normal mobility of the shoulder joint. Later on in the rehabilitation process, physical therapists will include strengthening of the rotator cuff musculature as well as strengthening of the muscles surrounding
the scapula (shoulder blade).