Are you suffering from shoulder pain? Are you in pain as you reach up, bringing your arm to your back? The cause may be impingement or shoulder impingement syndrome.
What Is This Shoulder Jam?
We can simply describe it as the compression of the muscles that move the shoulder joint between the bones. The inflammatory reaction caused by squeezing and crushing can also be explained to the patients as ” edema and fluid accumulation in the shoulder “.
Are Frozen Shoulder and Shoulder Impingement the Same Thing?
No, the two are different. In frozen shoulder ( adhesive capsulitis ), the arm is almost frozen due to the shrinkage and adhesion of the joint capsule, and its movements are severely restricted. In shoulder impingement, movements are also restricted, but this is due to pain. Because movements such as bringing the arm back and lifting it up increase the compression. However, if shoulder impingement syndrome is not treated early, the event may go towards frozen shoulder due to long-term avoidance of arm movements.
What Is A Shoulder Jam? Let’s Expand A Little More
The rotator cuff, or with its literal Turkish translation, the rotator cuff muscles are the four muscles that connect the arm (humerus) bone to the shoulder. They help raise and rotate our arm. The rotator cuff muscles are located under the acromion of the scapula. When we raise the arm up, the distance between the acromion and the muscles decreases. In shoulder impingement, the rotator cuff snaps or rubs against the acromion. In this region, there is a structure called the ” subacromial bursa “, which allows the acromion and the muscles to move without friction . Due to the compression, the bursa may become inflamed and a problem called bursitis may develop (the doctor may say that you have edema in your shoulder). A condition called impingement syndrome occurs due to the pressure acting on the muscles. If compression is neglected, this problem can lead to tendonitis (tendinitis ) and may progress to ruptures. Tendon tears initially develop partially, over time, there may be a full-thickness tear or even tendon rupture.
Who Gets Shoulder Impingement Syndrome?
It is a common cause of shoulder pain in athletes who use their arms a lot, such as swimmers and basketball players. Construction workers, painters and load carriers who constantly raise and lower their arms for work are also at risk for shoulder impingement. Sometimes structural differences in the shape of the shoulder bones and joint calcification associated with aging may also predispose to compression. Having a previous shoulder dislocation can also increase the risk.
What Causes Shoulder Impingement?
Impingement syndrome is most commonly caused by overuse . In cases where the shoulder makes certain movements repeatedly, muscle tendons may become edematous; Irregularities occur in the fibers and may become attached to the acromion bony prominence. Sometimes structurally, the acromion bone is like a hook, and therefore, the person may be predisposed to shoulder impingement.
What Are the Symptoms of Impingement of the Shoulder?
- Pain in the shoulder when raising the arm overhead and bringing it to the back.
- Mild pain may continue continuously even when not moving.
- The pain radiates from the front of the shoulder to the side of the arm, and may worsen at night.
- Lying on the affected side shoulder causes pain.
- May cause weakness in the arm.
Which Section to Go to for Shoulder Impingement?
If shoulder pain and limitation of movement do not occur as a result of a sudden trauma, you may first be examined by a physical therapy and rehabilitation doctor. In case of shoulder pain that starts as a result of sudden trauma, you should be examined by an orthopedic and traumatology doctor.
How Is Impingement Syndrome Recognized?
Your doctor first listens to your complaints. He questions the nature of your pain, its duration, factors that increase and decrease it, and other accompanying symptoms. He or she will ask if you have had a previous injury and your sports habits. Next comes the physical examination . It tests and measures the extent to which your arm can perform certain movements with various methods. It checks whether the complaints increase with maneuvers that provoke compression. Problems in the bones can be seen with X-ray film. For example, spiny protrusions at the ends of the bones due to joint calcification or abnormal growth of the bone, tendon calcification show symptoms on the film. If a tear in the tendon fibers is suspected, MRI of the shoulder joint (ema) or ultrasound may be performed.can be viewed with When ultrasonography is performed by an experienced doctor, tendon slippage during arm movements can be monitored dynamically and can better show the impingement.
How Is Shoulder Impingement Treated?
In the treatment of impingement syndrome, rest is recommended in the acute period, that is, in the days when the complaints first appear . Cold application can be done for 15 minutes 4-5 times a day for a few days . In chronic problems, hot application is recommended. Forceful movements that aggravate the pain should be avoided. However, it is not good for the arm to remain completely still. Being inactive causes joint stiffness and muscle wasting.
Physical therapy usually gives good results. Exercises are essential to recovery. Gentle stretching exercises are performed to normalize range of motion, and strengthening exercises are performed to restore muscle strength.
Non-steroidal anti-inflammatory drugs can be prescribed for several weeks to reduce pain and edema . Since these drugs can cause various side effects, especially stomach disorders, they should be used under the supervision of a doctor. If the drugs in the form of tablets and creams are not enough, local injection ( injection ) containing corticosteroids can be applied to the shoulder.
In rare cases where physical therapy is not effective, surgery may be required to widen the area where the tendons and muscle fibers are located .
Impingement Syndrome Exercises
You should consult your doctor in terms of exercises that are suitable for you. Here, we have described some movements to give you an idea.
In order to prevent and recover from shoulder impingement , you should be careful to stay in the correct posture throughout the day . For this, your spine and shoulders should be in a neutral position while sitting, standing and lifting loads.
You can do the following exercises 3-5 sets per day.
Squeezing the shoulder blades : While sitting or standing upright, bring your shoulder blades closer together, as if trying to squeeze something between them. Stay like that for 5 seconds. Repeat 10 times.
Rotation: While sitting or standing upright, rotate your arms outward at your sides and at the same time try to lengthen them in a downward direction. Stay like that for 5 seconds. Repeat 10 times.
Pectoral stretch: The large broad muscle in the front of our chest is the pectoral muscle. To stretch this muscle, hold a door sill slightly below shoulder level. Rotate your body to the other side until you feel a stretch in your chest. Hold for 15 seconds and repeat 5 times.
You can do the next moves once a day.
Distraction: Hold onto a support, such as the back of a table or chair, with your fingers and arm extended. Pull your torso back until you feel a stretch in your shoulder. Hold for 3 seconds, repeat 5 times.
Theraband pull: Pass the theraband, which you hold by the ends with both hands, over a solid support point such as a door handle, squeeze your shoulder blades and pull it towards you as if you are rowing. Do 15-20 reps.
External rotation with Theraband: Roll a towel and tuck it under your arm while standing. Your elbow should be bent 90 degrees. Attach theraband to a door in front of you. Without moving your shoulders, rotate your arm outward. Do 15-20 reps.
Shoulder Impingement Surgery
The surgery is performed with a closed method ( arthroscopic ). It can be used for both diagnosis and treatment. A small incision is made on the skin, and a camera called an arthroscope is entered. The structures in the shoulder are examined and the problems are determined. Inflamed and damaged tissues can be cleaned and removed. If there is excessive bone growth, it can be shaved. If there is a tear in the shoulder muscles or cartilage, it can be repaired. When the procedures are finished, the incision is stitched and the dressing is done. It is necessary to rest for a while and use a shoulder strap. Recovery time can take from 1 to 6 months. Physical therapy and exercises should be applied to return to normal life .