The amount of people who deal with pain in their shoulders is astonishing. In many cases, it is not just the people throwing, lifting weights, or doing overhead work that has painful shoulders. It is the receptionists. It is the IT department. It is the sales associates. Shoulder pain affects people from all walks of life. Shoulder impingement is the most common issue that occurs with shoulder pain. This diagnosis has come under scrutiny recently, and some of the scrutiny is warranted; shoulder impingement is still a problem that occurs early on in many shoulders, leading to more damage.
The first step in treating shoulder impingement is to identify it. There are three tests you can do at home for this:
1. The first test is to assess shoulder flexion
2. The second is to examine shoulder rotation
3. The third test is a shoulder stress test
If one of these tests were positive, you likely have a mild case of shoulder impingement. If all of these tests were positive, you likely have a more severe case of shoulder impingement.
If you are still reading this, the good news is there are many things we can do to treat shoulder impingement. The first place we like to start with treatment is chiropractic manipulation of the thoracic spine, clavicle, scapula, and humerus. Manipulation will improve the joint range of motion of the thoracic spine and shoulder girdle and decrease any muscle tension that may be present. Once the joints move freely, therapeutic exercise is incorporated to improve the range of motion, stability, and strength. Here is my top exercise for mobility.
Manipulation and exercise are the foundations for treatment, but some people with more severe restrictions may need more treatment. One additional treatment is instrument-assisted soft tissue mobilization (IASTM). IASTM has two primary tools, scraping and cupping. Scraping uses tools to apply compression to remodel soft tissue, increase the range of motion, and decrease pain. Cupping decompresses the soft tissue and accomplishes the same result as scraping but through the opposite mechanisms.
Other treatment options within our clinic for shoulder impingement are electrical muscle stimulation and therapeutic ultrasound. Electrical muscle stimulation uses electrical impulses to mimic muscular contractions and relaxation. This contract and relaxation cycle will decrease pain and relieve muscle spasms within the shoulder. Therapeutic ultrasound uses a high-frequency sound wave to promote healing and reduce pain and inflammation within the shoulder. There is one caveat with electrical muscle stimulation and therapeutic ultrasound. These modalities work mainly in decreasing pain, and while this is an important step, these do nothing to improve mobility, stability, or strength. These modalities work best alongside manipulation and therapeutic exercise.
One last treatment option for shoulder impingement is therapeutic taping. Often called kinesiotaping, this method involves using elastic tape to provide support, stability, and proprioception to muscles, joints, and ligaments. Proprioception refers to the body's ability to sense its position, movement, and orientation in space. It involves the integration of information from various sensory systems, such as the muscles, joints, and inner ear, to provide the brain with information about the body's position and movements. Kinesiotaping is highly effective at increasing proprioception within the body due to the constant input received.
Shoulder impingement presents with decreased mobility and loss of strength. It is often a precursor to more severe injuries such as rotator cuff or labral tears. A multifaceted treatment approach that lessens pain; and improves mobility, stability, strength, and proprioception will lower the severity of shoulder impingement. This strategy will build a more resilient shoulder and decrease your risk of developing shoulder injuries later in life.
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