Shoulder impingement is a common diagnosis that typically affects young overhead athletes and many adults.
The shoulder joint is where the upper arm bone (called the humerus), meets your collarbone (clavicle) and shoulder blade (scapula). Within this joint there is typically a subacromial space which holds a bursa. This bursa is a fluid filled sack that acts as a cushion in your shoulder to ensure that nothing pinches and there is room for the muscles to move and glide. Shoulder impingement happens when this space decreases, causing structures to hit or pinch each other. This will cause pain especially with reaching but it can also lead to damage. Think of putting a rope over a rock and pulling it back and forth, you will eventually get fraying of that rope and could even cause it to snap. That is the same concept within your shoulder. As you get pain with reaching it most likely means tendons are getting pulled over that "rock" or bone which can lead to irreversible damage. If not addressed this can lead to rotator cuff tears.
In life we are always lifting up and forward: lifting up our child, reaching into a cabinet, reaching overhead to close the trunk of our car, reaching for items in the grocery store. We are also hunched forward all day over our computer and phones. We don't pull down or back quite as much causing an imbalance in the muscles of the shoulder. When this imbalance happens the arm the arm bones rides up and forward in the shoulder joint causing less joint space which then causes things to pinch!
It is important to respect your pain and do exercises to increase that joint space!
So the real question is, how do you fix it?
1. Stretching the tight, over used muscles
2. Strengthen the underused pulling muscles
3. Focus on your posture
These 3 steps will help to increase your joint space so less things get pinched and are explained in more detail below. Check out our exercise guide for shoulder impingement under the resource page.
STRETCHING: All day we are hunched over our computers or phones causing our shoulders to roll forward. Stretching should focus on just the opposite- stretching your arms and shoulders back to open your chest. A doorway stretch as shown in the exercise sheet is a great way to do this. Add this stretch in throughout your work day; everytime you take a coffee or bathroom break do this stretch!
STRENGTHENING: Exercises should focus on pulling down and back to counteract all the forward and overhead reaching you do. An exercise sheet can be downloaded in the resource page. The focus is to work your posterior muscles. These exercises should be completed several times a week. They are great to do intermittently during the day as they help to wake up muscles that arent working as much as they should. BONUS these will help to improve your posture.
POSTURAL ADJUSTMENTS: When we have poor posture your arm bone rolls forward and can cause more to hit and pinch. By focusing on your posture and pulling your shoulders down and back you can help to counterbalance this. Intermittently throughout your work day, squeeze your shoulder blades down and back just for 10 repetitions every hour. Also check your work station set up. Your computer monitor should be at or slightly below eye height. Your keyboard should be kept low, at stomach height so, elbow can be bent to 90 degrees and wrists in neutral position. A computer stand and a bluetooth keyboard can be a great way to help improve your set up when using a laptop.
Be consistent with all of these steps over several months. if you continue to have pain, consult your doctor or see a therapist in person to get more personalized care.
More questions? Send us a message for customized exercise plans and in person services. We can help to provide care or point you in the right direction!
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